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Individual

DR. BRIAN LEE GREEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
997 E COUNTY LINE RD, SUITE M, GREENWOOD, IN 46143-1052
(317) 881-8119
Mailing address
997 E COUNTY LINE RD, SUITE M, GREENWOOD, IN 46143-1052
(317) 881-8119

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001136A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000526653
ANTHEM
IN
05
100324790A
IN
Enumeration date
12/31/2006
Last updated
05/12/2008
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