Individual
KELLY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3014 BOAIRES LN, LOUISVILLE, KY 40220-2428
(502) 855-1271
Mailing address
3014 BOAIRES LN, LOUISVILLE, KY 40220-2428
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-003523
KY
Other
Enumeration date
08/29/2014
Last updated
08/29/2014
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