Individual
MADISON GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
3337 NAIL RD, WARRIOR, AL 35180-3129
(205) 306-7851
Mailing address
3337 NAIL RD, WARRIOR, AL 35180-3129
(205) 306-7851
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3898
AL
Other
Enumeration date
12/08/2014
Last updated
12/08/2014
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