# GREENLEAF SOFT TISSUE THERAPY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942897459
- **Authorized official:** MRS. MARISSA SPENCER (OWNER/MANAGER)
- **Authorized official phone:** (610) 452-9021

## Contact information

- **Practice address:** 32 MARKET ST, BANGOR, PA 18013-1902
- **Practice address phone:** (610) 452-9021
- **Mailing address:** 32 MARKET ST, BANGOR, PA 18013-1902
- **Mailing address phone:** (610) 452-9021

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111N00000X | Chiropractor | — | NULL | — |
| 111N00000X | Chiropractor | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | Yes |
| 208D00000X | General Practice Physician | — | — | Yes |
| 225700000X | Massage Therapist | — | NULL | — |
| 225700000X | Massage Therapist | — | — | — |

## Other

- **Enumeration date:** 12/30/2020
- **Last updated:** 07/12/2021