NPI 1285935965

Amanda Green

Practitioner Massage Therapist Bridgeport, WV

Practice location

Address: 529 E Main St, Bridgeport, WV 26330-1824
Phone: (304) 842-4204
Fax: (304) 842-6480

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X

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Registry record

NPI: 1285935965
Entity type: Individual
Sex (as registered): Female
NPI issued: 10 Nov 2010
Record last updated: 9 Jan 2013

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.