Provider Demographics
NPI:1326170622
Name:GREENE, BETH C (DC)
Entity Type:Individual
Prefix:DR
First Name:BETH
Middle Name:C
Last Name:GREENE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 WATER ST
Mailing Address - Street 2:
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6229
Mailing Address - Country:US
Mailing Address - Phone:978-374-1084
Mailing Address - Fax:978-374-1043
Practice Address - Street 1:2 WATER ST
Practice Address - Street 2:
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6229
Practice Address - Country:US
Practice Address - Phone:978-374-1084
Practice Address - Fax:978-374-1043
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2012-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH7840307111N00000X
MA2032111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAY36450OtherBCBS
MAY36450OtherBCBS
MAY45066Medicare ID - Type Unspecified