ELY GREEN, OTA/L

Occupational Therapy Assistant

Active Individual
NPI: 1174716260

Practice Address

13 NORTHTOWN DR
SUITE 110
Jackson, MS 39211

Phone: (601) 206-9195

Specialties

Specialty Code Primary License
Occupational Therapy Assistant 224Z00000X Yes TA1448 (MS)

Frequently Asked Questions

NPI 1174716260 is the National Provider Identifier for ELY GREEN, OTA/L, a Occupational Therapy Assistant provider located in Jackson, MS. This NPI was enumerated on August 22, 2007.
ELY GREEN, OTA/L practices at 13 NORTHTOWN DR, SUITE 110, Jackson, MS 39211.

Quick Facts

NPI
1174716260
Type
Individual
Enumerated
Aug 22, 2007
Last Updated
Aug 22, 2007

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