Randall Green, PT

NPI #1457352056 in Benton, Arkansas

Provider Information

NPI Number: 1457352056
Entity Type: Individual
Name: Randall Green, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Aug 3, 2005
Last Updated: Jun 5, 2008

Practice Location

Address: 1115 FERGUSON DR
City: Benton
State: Arkansas
ZIP Code: 72015-3512
Phone: (501) 315-0639

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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