Individual
MRS. LA-WAN ANTONETTE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2931 E PEPPERIDGE DR, LANCASTER, TX 75134-2034
(972) 227-0180
Mailing address
2931 E PEPPERIDGE DR, LANCASTER, TX 75134-2034
(972) 227-0180
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT103655
TX
Other
Enumeration date
01/09/2008
Last updated
01/09/2008
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