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Individual

JENNIFER R GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSPT

Contact information

Practice address
1126 MIDDLESEX STREET, SUITE 3, LOWELL, MA 01851
(978) 459-4445
(978) 459-7555
Mailing address
1126 MIDDLESEX STREET, SUITE 3, LOWELL, MA 01851
(978) 459-4445
(978) 459-7555

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
16296
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0710652
MA
Enumeration date
05/16/2007
Last updated
07/08/2007
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