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Individual

DAVID EDWARD GREEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
43490 YUKON DR STE 212, ASHBURN, VA 20147-7326
(703) 729-7920
(703) 729-7923
Mailing address
2412 PARKVIEW DR, GAUTIER, MS 39553-2256
(228) 238-9660

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
CP007774T
VA
225100000X
Physical Therapist
PT7190
MS
225100000X
Physical Therapist

Other

Enumeration date
07/12/2022
Last updated
08/16/2022
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