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NPI Code Detail

MEDICARE: ALISHA LYNN GREENE DPT

MEDICARE: ALISHA LYNN GREENE DPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT024418PA

General Provider Information

NPI Number : 1144602079
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALISHA LYNN GREENE DPT
Provider Business Mailing Address
First Line : 710 LINCOLN GARDENS RD
Second Line :
City : EPHRATA
State : PA
Zip : 17522-8428
Country : US
Telephone Number : 717-926-5245
Fax Number :
Provider Business Practice Location Address
First Line : 1351 WALNUT RD
Second Line :
City : HONEY BROOK
State : PA
Zip : 19344-1233
Country : US
Telephone Number : 610-273-4304
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2015
Last Update Date : 10/12/2015

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