Individual
TIFFANY GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
319 N MAIN ST, SUMTER, SC 29150-4258
(803) 434-6155
Mailing address
319 N MAIN ST, SUMTER, SC 29150-4258
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
LL95086
SC
Other
Enumeration date
04/01/2025
Last updated
07/18/2025
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