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Individual

MISS JESSICA MARIE GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MMP, LMT

Contact information

Practice address
236 WAYNE ST, SANDUSKY, OH 44870-2637
(419) 366-4612
Mailing address
101 NORRIS DR, CLYDE, OH 43410-2071
(419) 680-3996

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
33.015705
OH

Other

Enumeration date
01/17/2013
Last updated
01/17/2013
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