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Individual

DR. BOBBY G. GREEN

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
RT. 60 & CANNELTON HOLLOW RD., SMITHERS, WV 25186
(304) 442-5188
(304) 442-5188
Mailing address
CANNELTON HOLLOW RD., P.O. BOX 200, SMITHERS, WV 25186
(304) 442-5188
(304) 442-5188

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
WV705
WV

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
225670
CARELINK
WV
01
7139239
AETNA
WV
01
P00254800
RAILROAD MEDICARE
WV
Enumeration date
11/22/2005
Last updated
07/08/2007
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