Individual
NICHOLAS GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
BCTMB, NCTMB, HHP
Contact information
Practice address
1809 19TH ST, SACRAMENTO, CA 95811-6745
(916) 256-3000
Mailing address
1809 19TH ST, SACRAMENTO, CA 95811-6745
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
82703
CA
226300000X
Kinesiotherapist
803905
CA
Other
Enumeration date
06/22/2017
Last updated
04/20/2023
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