Individual
LYDIA GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3204 SCARBOROUGH WAY, VIRGINIA BEACH, VA 23453-3055
(757) 201-2225
Mailing address
3204 SCARBOROUGH WAY, VIRGINIA BEACH, VA 23453-3055
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
09/22/2017
Last updated
09/22/2017
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