Individual
MRS. HEIDI ELLEN GREENE
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
32 BROAD STREET RD, TUCKAHOE PHYSICAL THERAPY CORP, MANAKIN SABOT, VA 23103-2213
(804) 784-7090
(804) 784-7092
Mailing address
2415 IRISDALE AVE, RICHMOND, VA 23228
(804) 264-3397
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305004914
VA
Other
Enumeration date
05/24/2006
Last updated
07/08/2007
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