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NPI Code Detail

MEDICARE: ELIZABETH GREEN PT, DPT

MEDICARE: ELIZABETH GREEN PT, 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 TherapistP19280NC

General Provider Information

NPI Number : 1447899299
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH GREEN PT, DPT
Provider Business Mailing Address
First Line : 1210 TOPSAIL COMMON DR APT 206
Second Line :
City : KNIGHTDALE
State : NC
Zip : 27545-7118
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2503 WAYNE MEMORIAL DR
Second Line :
City : GOLDSBORO
State : NC
Zip : 27534-9401
Country : US
Telephone Number : 919-734-1311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2019
Last Update Date : 03/19/2026

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