MEDICARE: DR. BRIAN ROBERT GREEN D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC006907L	PA

General Provider Information

NPI Number	:	1932153327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN ROBERT GREEN D.C.

Provider Business Mailing Address
First Line	:	783 PINE VALLEY DR
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15239-2842
Country	:	US
Telephone Number	:	724-733-2225
Fax Number	:	724-733-2500

Provider Business Practice Location Address
First Line	:	783 PINE VALLEY DR
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15239-2842
Country	:	US
Telephone Number	:	724-733-2225
Fax Number	:	724-733-2500

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/20/2006
Last Update Date	:	09/28/2011

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Directions to “ DR. BRIAN ROBERT GREEN D.C.” Practice Location

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