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Individual

ALLISON GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MPT

Contact information

Practice address
1778 FOUNTAIN DR, RESTON, VA 20190-3390
(571) 926-9398
Mailing address
13140 ASHNUT LN, HERNDON, VA 20171-4302
(703) 390-0545

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
22106
CA
225100000X
Physical Therapist
Primary
2305006317
VA

Other

Enumeration date
03/14/2012
Last updated
09/19/2013
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