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Individual

MISS JENNIFER J GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
25825 VERMONT AVE, HARBOR CITY, CA 90710-3518
(310) 517-2188
(310) 517-2124
Mailing address
25825 VERMONT AVE, HARBOR CITY, CA 90710-3518
(310) 517-2188
(310) 517-2124

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT33699
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PT33699
PHYSICAL THERAPIST
CA
Enumeration date
09/23/2007
Last updated
12/02/2021
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