Individual
KHADIJAH GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
219 BILL SALLEY RD, ORANGEBURG, SC 29115-8769
(803) 664-0801
Mailing address
219 BILL SALLEY RD, ORANGEBURG, SC 29115-8769
(803) 664-0801
Taxonomy
Speciality
Code
Description
License number
State
163WM1400X
Nurse Massage Therapist (NMT)
Primary
264307
SC
Other
Enumeration date
03/12/2026
Last updated
03/12/2026
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