Individual
MRS. JESSICA GREENE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
926 LA CHERE ST, BEAUFORT, SC 29902-4010
(850) 723-0572
Mailing address
926 LA CHERE ST, BEAUFORT, SC 29902-4010
(850) 723-0572
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
1499
SC
Other
Enumeration date
11/13/2007
Last updated
03/13/2008
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