Healthcare Provider Details

I. General information

NPI: 1083624845
Provider Name (Legal Business Name): THOMAS H GREEN D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1713 W US HIGHWAY 160 SUITE 215
WEST PLAINS MO
65775-7669
US

IV. Provider business mailing address

1134 W MAPLEWOOD ST
SPRINGFIELD MO
65807-4763
US

V. Phone/Fax

Practice location:
  • Phone: 417-257-1184
  • Fax:
Mailing address:
  • Phone: 417-886-8133
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number005235
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number005235
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: