Provider Demographics
NPI:1912070392
Name:GREENFIELD WELLNESS CENTER
Entity Type:Organization
Organization Name:GREENFIELD WELLNESS CENTER
Other - Org Name:IATRIA HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:GREENFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:919-861-8944
Mailing Address - Street 1:8020 CREEDMOOR RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27613-4363
Mailing Address - Country:US
Mailing Address - Phone:919-861-8944
Mailing Address - Fax:919-861-8943
Practice Address - Street 1:8020 CREEDMOOR RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27613-4363
Practice Address - Country:US
Practice Address - Phone:919-861-8944
Practice Address - Fax:919-861-8943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC3447111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty