Individual
MITCHELL GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
70 PENNINGTON DR, #9, BLUFFTON, SC 29910-6055
(843) 815-3131
Mailing address
926 LA CHERE ST, BEAUFORT, SC 29902-4010
(843) 379-6369
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1438
LICENSE #
SC
Enumeration date
08/30/2006
Last updated
07/08/2007
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