Individual
CODY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
24 BRIDLEWOOD RD, CHARLESTON, WV 25314-2101
(304) 550-6935
Mailing address
400 TRACY WAY STE 100, CHARLESTON, WV 25311-1280
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
002581
WV
Other
Enumeration date
12/02/2024
Last updated
12/02/2024
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