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General NPI Number Information
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NPI Number | 1306960463
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Entity Type | Individual
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Provider Name | CHRISTOPHER R GREENE D.C
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Gender | Male
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Dates
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Enumeration Date | 03/16/2007
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Last Update Date | 12/12/2018
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Provider Practice Location Address
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Address Line | 2300 FOOTHILL BLVD STE A
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City | LA VERNE
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State | CA
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Zip | 91750-3064
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Country | US
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Telephone | 909-392-9700
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Fax |
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Provider Business Mailing Address
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Address Line | 9252 HIDDEN VALLEY DR
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City | VILLA PARK
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State | CA
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Zip | 92861-2306
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Country | US
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Telephone | 714-949-0724
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Fax |
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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 | CHR-4676
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License Number State | CO
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