Provider Demographics
NPI:1710044367
Name:GREENHAW, FRANK JAWAYNE JR (DC)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:JAWAYNE
Last Name:GREENHAW
Suffix:JR
Gender:M
Credentials:DC
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Mailing Address - Street 1:GREENHAW CHIROPRACTIC
Mailing Address - Street 2:1805 N YORK STE H
Mailing Address - City:MUSKOGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74403
Mailing Address - Country:US
Mailing Address - Phone:918-686-7107
Mailing Address - Fax:918-686-7125
Practice Address - Street 1:1805 N YORK STE H
Practice Address - Street 2:
Practice Address - City:MUSKOGEE
Practice Address - State:OK
Practice Address - Zip Code:74403
Practice Address - Country:US
Practice Address - Phone:918-686-7107
Practice Address - Fax:918-686-7125
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OK3377111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U88330Medicare UPIN