Organization
GREEN CLINIC LLC
Active
Parent organization
GREEN CLINIC
Other names
Green Clinic Rehabilitation Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
GREEN CLINIC
Authorized official
MRS. INDIA CARROLL (CEO)
(318) 255-3690
Entity
Organization
Contact information
Practice address
1200 S FARMERVILLE ST, RUSTON, LA 71270-5941
(318) 251-6103
(318) 251-6141
Mailing address
PO BOX 1594, RUSTON, LA 71273-1594
(318) 251-6103
(318) 251-6141
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
08/22/2006
Last updated
02/13/2019
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