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Individual

WILEY A GREENE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DC

Contact information

Practice address
1914 EUCLID AVE, BRISTOL, VA 24201-3608
(276) 642-0107
(276) 642-0347
Mailing address
1914 EUCLID AVE, BRISTOL, VA 24201-3608
(276) 642-0107
(276) 642-0347

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
0104000940
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
6708935
VA
Enumeration date
05/04/2006
Last updated
12/13/2012
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