Individual
JEANNE GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
503 RIVER CLUB DRIVE, LAGRANGE, GA 30240-7792
(404) 861-0031
Mailing address
503 RIVER CLUB DR, LAGRANGE, GA 30240-7792
(404) 861-0031
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
3516
GA
2251P0200X
Pediatric Physical Therapist
Primary
3516
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000595944E
—
GA
01
—
10040357
AMERIGROUP NUMBER
GA
01
—
321854
WELLCARE NUMBER
GA
01
—
3516
GEORGIA PT LICENSE
GA
Enumeration date
12/11/2006
Last updated
01/15/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us