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General NPI Number Information
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NPI Number | 1346572427
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Entity Type | Organization
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Legal Business Name | DR JAMES A GREEN PC
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Dates
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Enumeration Date | 02/01/2010
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Last Update Date | 02/15/2010
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Provider Practice Location Address
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Address Line | 400 SE 3RD ST
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City | LEES SUMMIT
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State | MO
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Zip | 64063-2823
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Country | US
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Telephone | 816-525-3630
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Fax | 816-524-3630
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Provider Business Mailing Address
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Address Line | PO BOX 878
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City | LEES SUMMIT
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State | MO
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Zip | 64063-0878
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Country | US
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Telephone | 816-525-3630
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Fax | 816-524-3630
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES A GREEN
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Credential | DC
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Telephone | 816-525-3630
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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 | 004304
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License Number State | MO
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