Healthcare Provider Details

I. General information

NPI: 1508044389
Provider Name (Legal Business Name): DR. JOEL GREEN, D.C., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2008
Last Update Date: 02/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

310 LAFAYETTE ST
SALEM MA
01970-5442
US

IV. Provider business mailing address

310 LAFAYETTE ST
SALEM MA
01970-5442
US

V. Phone/Fax

Practice location:
  • Phone: 978-744-1123
  • Fax: 978-744-9683
Mailing address:
  • Phone: 978-744-1123
  • Fax: 978-744-9683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number
License Number State

VIII. Authorized Official

Name: DR. JOEL G. GREEN
Title or Position: PRESIDENT
Credential: D.C.
Phone: 978-744-1123