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Organization
DR REBECCA GREEN
Active
Organization
DR REBECCA GREEN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REBECCA A GREEN DC DACBSP (OWNER)
(860) 537-8900
Entity
Organization
Contact information
Practice address
121 BROADWAY, SUITE 2, COLCHESTER, CT 06415
(860) 537-8900
(860) 537-8868
Mailing address
121 BROADWAY, SUITE 2, COLCHESTER, CT 06415
(860) 537-8900
(860) 537-8868
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
001023
CT
111N00000X
Chiropractor
0CP00506
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050001023CT04
BLUE CROSS BLUE SHIELD
CT
01
—
3984974
AETNA
CT
01
—
CT01023
HEALTHNET
CT
Enumeration date
12/13/2006
Last updated
08/22/2020
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