Individual
TARYN GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3950 SUMAC DR, TRAVERSE CITY, MI 49684-7009
(231) 714-6516
Mailing address
502 S HIGH ST, RANDOLPH, WI 53956-1499
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
2555
WI
225200000X
Physical Therapy Assistant
Primary
5502004992
MI
225200000X
Physical Therapy Assistant
—
—
Other
Enumeration date
01/11/2017
Last updated
05/27/2024
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