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Individual

RYAN GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
9108 PA-198, CONNEAUTVILLE, PA 16406
(814) 587-2012
Mailing address
327 ORCHID LN, SLIPPERY ROCK, PA 16057-5229
(724) 996-6793

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
TE011793
PA

Other

Enumeration date
10/04/2018
Last updated
10/04/2018
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