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General NPI Number Information
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NPI Number | 1255395661
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Entity Type | Individual
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Provider Name | TERESA A GREEN D.C.
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Gender | Female
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Dates
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Enumeration Date | 04/13/2006
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 5700 OLD RICHMOND AVE STE A4
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City | RICHMOND
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State | VA
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Zip | 23226-1828
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Country | US
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Telephone | 804-477-3194
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Fax | 804-477-3324
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Provider Business Mailing Address
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Address Line | PO BOX 293
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City | GUM SPRING
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State | VA
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Zip | 23065-0293
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Country | US
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Telephone | 804-477-3194
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Fax | 804-477-3324
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104556283
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License Number State | VA
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