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General NPI Number Information
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NPI Number | 1841319274
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Entity Type | Individual
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Provider Name | ANITA JO GREEN P.T.
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Gender | Female
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Dates
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Enumeration Date | 03/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 3233 S WILLIS ST
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City | ABILENE
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State | TX
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Zip | 79605-6649
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Country | US
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Telephone | 325-692-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 3541 HUNTERS GLEN RD
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City | ABILENE
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State | TX
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Zip | 79605-4921
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Country | US
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Telephone | 325-691-1761
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 145987
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License Number State | TX
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