Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 6496 | SC |
Y | 225100000X | Physical Therapist | 6496 | SC |
N | 225X00000X | Occupational Therapist | ||
N | 225XH1200X | Occupational Therapist - Hand |
NPI | 1083993158 |
---|---|
Provider Name | Virginia Lee Greene |
First Address | North Charleston, SC 29406-9236 |
Second Address | Columbia, SC 29201-2619 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2011 |
Last Update Date | 20/11/2012 |