Individual
HEATHER ADELL GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
21 E STATE ST, WELLSVILLE, NY 14895-1388
(585) 593-1321
Mailing address
4406 RIVER ST APT 2, SCIO, NY 14880-9517
(607) 220-8141
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
023358
NY
Other
Enumeration date
12/14/2022
Last updated
12/14/2022
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