Individual
DR. REBECCA A GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DC, DACBSP
Contact information
Practice address
121 BROADWAY ST, SUITE 2, COLCHESTER, CT 06415-1052
(860) 537-8900
(860) 537-8868
Mailing address
PO BOX 1632, MIDDLETOWN, CT 06457-8132
(860) 537-8900
(860) 537-8868
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
001023
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050001023CT04
ANTHEM BCBS
CT
01
—
3984974
AETNA
CT
01
—
CT01023
HEALTH NET
CT
Enumeration date
10/16/2007
Last updated
10/16/2007
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