Organization
ATLANTIC COAST CHIROPRACTIC, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MITHRA JIGME GREEN D.C. (OWNER)
(757) 313-6723
Entity
Organization
Contact information
Practice address
5267 GREENWICH RD, SUITE 201, VIRGINIA BEACH, VA 23462-6028
(757) 313-6723
(757) 313-4596
Mailing address
5267 GREENWICH RD, SUITE 201, VIRGINIA BEACH, VA 23462-6028
(757) 313-6723
(757) 313-4596
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104555605
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2282482
THE MAILHANDLER'S BENEFIT PLAN
VA
01
—
292354
ANTHEM BLUE CROSS BLUE SHIELD
VA
Enumeration date
08/01/2008
Last updated
08/01/2008
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