Individual
CORY JAMES GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
3000 RISEN SON BLVD, COUNCIL BLUFFS, IA 51503-1911
(712) 366-9655
Mailing address
3000 RISEN SON BLVD, COUNCIL BLUFFS, IA 51503-1911
(712) 310-9111
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
005132
IA
Other
Enumeration date
11/03/2022
Last updated
11/03/2022
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