Healthcare Provider Details

I. General information

NPI: 1578487021
Provider Name (Legal Business Name): JOSI GREEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 ROCK SPRINGS RD
SYLACAUGA AL
35151-5861
US

IV. Provider business mailing address

555 ROCK SPRINGS RD
SYLACAUGA AL
35151-5861
US

V. Phone/Fax

Practice location:
  • Phone: 205-784-6488
  • Fax: 205-784-6488
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number12636
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: