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1093103301
KATHERINE GREEN
INDEPENDENCE, MO
NPI
1093103301
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: MO 2011037565)
Enumeration Date
2015-01-08
Last Update Date
2015-01-08
Business Address
-- KATHERINE GREEN PTA
810 E WALNUT ST
INDEPENDENCE, MO 64050-4025
Phone number: 951-545-4013
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Mailing Address
-- KATHERINE GREEN PTA
3510 NE 61ST TER
GLADSTONE, MO 64119-1982
Phone number: 951-545-4013
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