Individual
EBONY L GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
620 OLD 30 RD APT 3, JACKSONVILLE, NC 28546-9751
(910) 382-5112
Mailing address
620 OLD 30 RD APT 3, JACKSONVILLE, NC 28546-9751
(910) 382-5112
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
21539
NC
Other
Enumeration date
03/17/2026
Last updated
03/17/2026
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