Individual
MICHAEL WAYNE GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
702 HIGHWAY 34 WEST, MARBLE HILL, MO 63764-4301
(573) 238-4272
Mailing address
702 HIGHWAY 34 W, MARBLE HILL, MO 63764-4301
(573) 238-4272
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2012001142
MO
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
10/24/2022
Last updated
10/24/2022
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