Individual
LATOYA L GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
920 MADISON AVE SUITE 415, MEMPHIS, TN 38163-1614
(901) 448-5888
(901) 448-1411
Mailing address
920 MADISON AVE STE 415, MEMPHIS, TN 38103-3469
(901) 448-5888
(901) 448-1411
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT3861
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0446645
—
TN
01
—
3133295
BC/BS
TN
01
—
446645
MEDICARE
TN
Enumeration date
04/26/2017
Last updated
10/13/2021
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