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General NPI Number Information
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NPI Number | 1205106846
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Entity Type | Individual
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Provider Name | WILLIAM A GREENE BS LMT
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Gender | Female
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Dates
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Enumeration Date | 01/11/2012
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Last Update Date | 01/23/2012
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Provider Practice Location Address
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Address Line | 154 PEARL ST
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City | BATAVIA
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State | NY
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Zip | 14020-2914
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Country | US
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Telephone | 585-993-5368
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Fax |
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Provider Business Mailing Address
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Address Line | 2599 ELMWOOD AVE 12 CORNERS BRIGHTON
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City | ROCHESTER
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State | NY
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Zip | 14618-2210
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Country | US
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Telephone | 585-943-0722
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 0222591
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License Number State | NY
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