Provider Demographics
NPI:1821264326
Name:GREENE CHIROPRACTIC PC
Entity Type:Organization
Organization Name:GREENE CHIROPRACTIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STUART
Authorized Official - Middle Name:HALL
Authorized Official - Last Name:GREENE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:307-637-7463
Mailing Address - Street 1:1507 STILLWATER AVE STE B
Mailing Address - Street 2:
Mailing Address - City:CHEYENNE
Mailing Address - State:WY
Mailing Address - Zip Code:82009-7358
Mailing Address - Country:US
Mailing Address - Phone:307-637-7463
Mailing Address - Fax:303-778-9814
Practice Address - Street 1:1507 STILLWATER AVE
Practice Address - Street 2:STE B
Practice Address - City:CHEYENNE
Practice Address - State:WY
Practice Address - Zip Code:82009-7358
Practice Address - Country:US
Practice Address - Phone:307-637-7463
Practice Address - Fax:303-778-9814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-05
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY366261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center