Provider Demographics
NPI:1740253467
Name:GREENSPAN, MICHELLE GAIL (DC)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:GAIL
Last Name:GREENSPAN
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 1:397 JOCASSEE LAKE RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:SC
Mailing Address - Zip Code:29676-2229
Mailing Address - Country:US
Mailing Address - Phone:864-944-6467
Mailing Address - Fax:864-944-6822
Practice Address - Street 1:261 ASHELAND AVE
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4054
Practice Address - Country:US
Practice Address - Phone:864-944-6467
Practice Address - Fax:864-944-6822
Is Sole Proprietor?:No
Enumeration Date:2006-02-13
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1659111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC08417OtherBLUE CROSS AND BLUE SHIEL
NC6908417Medicaid
T82539Medicare UPIN
NC08417OtherBLUE CROSS AND BLUE SHIEL