Provider Demographics
NPI:1346629011
Name:OCCUPATIONAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:OCCUPATIONAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:JEROME
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:620-276-8284
Mailing Address - Street 1:805 N MAIN ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5562
Mailing Address - Country:US
Mailing Address - Phone:620-276-8284
Mailing Address - Fax:620-267-6653
Practice Address - Street 1:805 N MAIN ST
Practice Address - Street 2:SUITE 2
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5562
Practice Address - Country:US
Practice Address - Phone:620-276-8284
Practice Address - Fax:620-267-6653
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-27
Last Update Date:2015-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0104066111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS1588617112OtherNPI