Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 12182 | CA |
NPI | 1386778058 |
---|---|
Provider Name | Dr. James M Greenlee |
First Address | Auburn, CA 95602-2002 |
Second Address | Auburn, CA 95602-2002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T04658 | (02) | CA |