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General NPI Number Information
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NPI Number | 1760154033
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Entity Type | Organization
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Legal Business Name | TERESA A GREEN DC PC
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Dates
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Enumeration Date | 10/04/2021
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Last Update Date | 10/26/2022
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Provider Practice Location Address
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Address Line | 5700 OLD RICHMOND AVE STE A4
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City | RICHMOND
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State | VA
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Zip | 23226-1828
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Country | US
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Telephone | 804-477-3194
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Fax | 804-477-3324
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Provider Business Mailing Address
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Address Line | 5700 OLD RICHMOND AVE STE A4
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City | RICHMOND
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State | VA
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Zip | 23226-1828
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Country | US
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Telephone | 804-477-3194
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Fax | 804-477-3324
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. TERESA GREEN
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Credential | DC
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Telephone | 804-477-3194
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number |
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License Number State |
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