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General NPI Number Information
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NPI Number | 1346629011
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Entity Type | Organization
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Legal Business Name | OCCUPATIONAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 05/27/2015
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Last Update Date | 05/27/2015
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Provider Practice Location Address
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Address Line | 805 N MAIN ST SUITE 2
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City | GARDEN CITY
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State | KS
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Zip | 67846-5562
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Country | US
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Telephone | 620-276-8284
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Fax | 620-267-6653
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Provider Business Mailing Address
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Address Line | 805 N MAIN ST SUITE 2
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City | GARDEN CITY
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State | KS
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Zip | 67846-5562
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Country | US
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Telephone | 620-276-8284
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Fax | 620-267-6653
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Authorized Official
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Title or Position | OWNER
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Name | DR. JAMES JEROME GREENE
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Credential | DC
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Telephone | 620-276-8284
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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 | 0104066
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License Number State | KS
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