Individual
ANDREA LEE JOHNSTON GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
16208 REMUDA TRL, BUDA, TX 78610-9349
(512) 619-3139
Mailing address
16208 REMUDA TRL, BUDA, TX 78610-9349
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1310
TX
Other
Enumeration date
01/23/2018
Last updated
01/23/2018
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