Individual
MS. NICOLE ELISE GREENE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC, LAT
Contact information
Practice address
211 EXECUTIVE DR, SUITE 11, NEWARK, DE 19702-3357
(302) 793-1800
Mailing address
75 N FAIRFIELD DR, SMYRNA, DE 19977-1516
(850) 339-4369
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AL3521
FL
Other
Enumeration date
05/23/2013
Last updated
01/07/2014
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