Individual
DR. JEFFREY A GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D C
Contact information
Practice address
108 ROSSMAN AVE, KNOX, PA 16232-1844
(814) 797-2863
(814) 797-2863
Mailing address
108 ROSSMAN AVE, KNOX, PA 16232-1844
(814) 797-2863
(814) 797-2863
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
DC004902L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012742240004
—
PA
01
—
212200
UPMC HEALTH PLAN
PA
01
—
336136
PA BLUE SHIELD
PA
Enumeration date
10/14/2005
Last updated
03/13/2008
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