Individual
DR. THOMAS A GREEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
321 W CENTRAL AVE, FITZGERALD, GA 31750-2441
(229) 423-2196
Mailing address
321 W CENTRAL AVE, FITZGERALD, GA 31750-2441
(229) 423-2196
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR004988
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000564154A
—
GA
Enumeration date
08/11/2005
Last updated
07/18/2012
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