| Doctor Name: | BRYAN THOMAS GREEN |
| NPI Number: | 1104115583 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT, DPT |
| License Number: | 005132 |
| Business Practice Address: | 1099 Medical Center Cir Mayfield, KY - 420661159 |
| Business Phone Number: | 2702514121 |
| Business Fax Number: | |
| Mailing Address: | 1512 W Broadway St, MAYFIELD |
| State: | KY |
| Postal Code: | 420661926 |
| Phone Number: | 2703562220 |
| Fax Number: | |
| NPI Enumeration Date: | 04/06/2011 |
| NPI Last Update Date: | 04/06/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 005132 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | KY |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |