Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | CH11128 | FL |
NPI | 1003144023 |
---|---|
Provider Name | Dr. Nicole Lauren Greenberg |
First Address | Scottsdale, AZ 85260-6960 |
Second Address | Fort Pierce, FL 34947-4750 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2009 |
Last Update Date | 05/12/2019 |