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Individual

TECKELA SAMYELL GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
8760 LANDMARK RD STE A, RICHMOND, VA 23228-2802
(804) 688-0000
(804) 774-7533
Mailing address
8760 LANDMARK RD, RICHMOND, VA 23228-2802
(804) 688-0000
(804) 774-7533

Taxonomy

Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary

Other

Enumeration date
05/02/2023
Last updated
05/09/2023
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