Individual
MICHAEL STEPHEN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
4570 CHURCHILL ST, SUITE 300, SHOREVIEW, MN 55126-2273
(651) 451-1071
(651) 481-0042
Mailing address
4200 DAHLBERG DR, SUITE 300, GOLDEN VALLEY, MN 55422-4840
(952) 512-5600
(952) 512-5651
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5941
MT
225100000X
Physical Therapist
P14894
NC
2251X0800X
Orthopedic Physical Therapist
Primary
9882
MN
Other
Enumeration date
06/04/2014
Last updated
03/05/2015
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