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General NPI Number Information
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NPI Number | 1437340395
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Entity Type | Organization
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Legal Business Name | MELISSA J GREENE CHIROPRACITC CORPORATION
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Dates
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Enumeration Date | 08/06/2007
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Last Update Date | 08/06/2007
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Provider Practice Location Address
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Address Line | 350 MCKINLEY STREET STE 102
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City | CORONA
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State | CA
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Zip | 92879
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Country | US
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Telephone | 951-737-4710
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Fax | 951-737-2485
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Provider Business Mailing Address
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Address Line | 350 MCKINLEY STREET STE 102
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City | CORONA
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State | CA
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Zip | 92879
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Country | US
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Telephone | 951-737-4710
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Fax | 951-737-2485
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Authorized Official
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Title or Position | OWNER
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Name | MEILSSA J GREENE
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Credential | CHIROPRACTIC
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Telephone | 951-737-4710
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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 | 27766
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License Number State | CA
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