Individual
MS. SHELLEY GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
24166 CORKTREE LN, ALDIE, VA 20105-2189
(703) 626-7747
Mailing address
24166 CORKTREE LN, ALDIE, VA 20105-2189
(703) 626-7747
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
0019008310
VA
Other
Enumeration date
11/02/2013
Last updated
11/02/2013
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