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Individual

MR. MARTY JOSEPH GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
1910 NURSING HOME RD, OWENSVILLE, MO 65066-2844
(573) 437-5510
Mailing address
1910 NURSING HOME RD, OWENSVILLE, MO 65066-2844
(573) 437-5510

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2008020867
MO

Other

Enumeration date
03/10/2015
Last updated
03/10/2015
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