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General NPI Number Information
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NPI Number | 1437395985
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Entity Type | Organization
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Legal Business Name | GREEN CHIROPRACTIC PC
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Dates
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Enumeration Date | 01/05/2009
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Last Update Date | 03/27/2014
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Provider Practice Location Address
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Address Line | 1161 N COTNER BLVD
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City | LINCOLN
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State | NE
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Zip | 68505-1835
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Country | US
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Telephone | 402-466-6454
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Fax | 402-466-7829
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Provider Business Mailing Address
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Address Line | 1161 N COTNER BLVD
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City | LINCOLN
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State | NE
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Zip | 68505-1835
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Country | US
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Telephone | 402-466-6454
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Fax | 402-466-7829
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Authorized Official
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Title or Position | DOCTOR/OWNER
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Name | DR. THOMAS L. GREEN
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Credential | DC
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Telephone | 402-466-6454
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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 | 838
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License Number State | NE
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