Individual provider · NPI-1

Teckela Samyell Green

Prosthetic/Orthotic Supplier · Richmond, VA

NPI number1700575180
StatusActive
Last updated in NPPESMay 9, 2023

Details

NPI
1700575180
Entity type
Individual (NPI-1)
Name
Teckela Samyell Green
Sex
Female
Sole proprietor
Yes
Enumeration date
May 2, 2023
Certification date
May 9, 2023
Last updated
May 9, 2023

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
335E00000X Prosthetic/Orthotic Supplier––Yes

Practice location

8760 Landmark Rd Ste A
Richmond, VA 23228-2802

Phone 804-688-0000 · Fax 804-774-7533

Mailing address

8760 Landmark Rd
Richmond, VA 23228-2802

Phone 804-688-0000 · Fax 804-774-7533

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