NPI 1154889129

Brody Mitchell Green, LPTA

Practitioner Physical Therapy Assistant Woodstock, GA

Practice location

Address: 4580 Towne Lake Pkwy, Woodstock, GA 30189
Phone: (678) 771-6459
Mailing address: 1824 Defoor Ave NW APT 2215, Atlanta, GA 30318-3029

Registered specialties

Physical Therapy Assistant Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225200000X Licence PTA004106 (GA)

Other Physical Therapy Assistant providers in Georgia →

Registry record

NPI: 1154889129
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Mar 2019
Record last updated: 7 Mar 2019

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.