Provider Demographics
NPI:1265017503
Name:GREENWICH BAY CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:GREENWICH BAY CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DEVON
Authorized Official - Middle Name:CEIN
Authorized Official - Last Name:BARLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:508-965-4658
Mailing Address - Street 1:50 BURLINGTON ST
Mailing Address - Street 2:
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906-3621
Mailing Address - Country:US
Mailing Address - Phone:508-965-4658
Mailing Address - Fax:
Practice Address - Street 1:16 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-3827
Practice Address - Country:US
Practice Address - Phone:508-965-4658
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center