Individual
MRS. MISTY LYNN GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
8437 STATE AVE, KANSAS CITY, KS 66112-1842
(913) 299-9616
Mailing address
4911 MILLRIDGE ST, SHAWNEE, KS 66226-9752
(913) 530-2779
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT 6624
CA
Other
Enumeration date
07/05/2007
Last updated
11/22/2010
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