Individual
JENNA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 DUBLIN RD, MANKATO, MN 56001-8765
(507) 385-7094
Mailing address
100 DUBLIN RD, MANKATO, MN 56001-8765
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
11921
MN
225100000X
Physical Therapist
14974
WI
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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