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DR. THOMAS A GREEN D.C.
>> Chiropractor >> Chiropractic ProvidersRegistrant NPI Number: 1861494718
Individual Registrant:DR. THOMAS A GREEN D.C.
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
321 W CENTRAL AVE FITZGERALD, GA 31750-2441 US
Tel: 229-423-2196 Fax: --
Tel: 229-423-2196 Fax: --
Contact information for business:
321 W CENTRAL AVE FITZGERALD, GA 31750-2441 US
Tel: 229-423-2196 Fax: --
Tel: 229-423-2196 Fax: --
Registration Information:
NPI: 1861494718
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 111N00000X | Chiropractic Providers Chiropractor | GA | CHIR004988 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
| 000564154A | GA | 05 |
