Doctor Name: | MR. EDWARD GLENDON GREENE |
NPI Number: | 1639258288 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MPH, PT |
License Number: | 5501006499 |
Business Practice Address: | 2500 Niles Rd Ste 8 Saint Joseph, MI - 490853237 |
Business Phone Number: | 2694287150 |
Business Fax Number: | 2694287152 |
Mailing Address: | 1456 Hideaway Ln, SAINT JOSEPH |
State: | MI |
Postal Code: | 490859711 |
Phone Number: | 2694080876 |
Fax Number: | |
NPI Enumeration Date: | 11/03/2006 |
NPI Last Update Date: | 06/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5501006499 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MI |
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 |