Individual
MRS. TAMARA M GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
301 REGENT ST, SUMMERVILLE, SC 29483-9719
(843) 771-2123
Mailing address
301 REGENT ST, SUMMERVILLE, SC 29483-9719
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
5310
SC
Other
Enumeration date
06/08/2008
Last updated
06/08/2008
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