Individual
LANA R GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
949 MOUNT HERMON RD, SALISBURY, MD 21804-5105
(410) 543-9000
(410) 543-9033
Mailing address
105 TIME SQ, SALISBURY, MD 21801-2808
(410) 543-9000
(410) 543-9033
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17381
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
071378301
—
MD
01
—
426175
MAMSI
MD
01
—
53381201
CAREFIRST
MD
01
—
S4020002
FEDERAL BCBS
MD
Enumeration date
04/24/2007
Last updated
01/27/2017
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