Individual
CHRISTINE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, ATC
Contact information
Practice address
7822 28TH AVE, KENOSHA, WI 53143-5622
(262) 764-0754
Mailing address
3420 ILLINOIS ST, GREAT LAKES, IL 60088-3161
(847) 688-6755
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
PT00005215
WA
Other
Enumeration date
09/08/2005
Last updated
03/07/2016
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