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Organization

JAMES E. GREATHOUSE, JR., DCPA

Active
Other names
Dr. James E. Greathouse, Jr.
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. MARILYN A GREATHOUSE (OFFICE MANAGER)
(321) 725-6314
Entity
Organization

Contact information

Practice address
1589 S WICKHAM RD, W MELBOURNE, FL 32904-3540
(321) 725-6314
(321) 724-1533
Mailing address
1589 S WICKHAM RD, W MELBOURNE, FL 32904-3540
(321) 725-6314
(321) 724-1533

Taxonomy

Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
Primary
CH4246
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
88014
MEDICARE PTAN
FL
Enumeration date
01/24/2012
Last updated
01/27/2012
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