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Individual

LIZA B GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
480 CENTRAL RD, BLOOMSBURG, PA 17815-3121
(570) 387-6150
(570) 387-6185
Mailing address
100 N ACADEMY AVE, DANVILLE, PA 17822-4903
(570) 271-6144
(570) 271-6578

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
4301074888
MI
208100000X
Physical Medicine & Rehabilitation Physician
Primary
MD459902
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
103256783
PA
05
4578635
MI
Enumeration date
10/19/2006
Last updated
03/03/2022
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