Organization
SPINE & SPORTS INJURY CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RICHARD LAWRENCE GREEN DC (PRESIDENT)
(617) 877-7754
Entity
Organization
Contact information
Practice address
209 COLUMBUS AVE, BOSTON, MA 02116-5109
(617) 247-2300
(617) 936-4196
Mailing address
1 DALTON ST UNIT 3404, BOSTON, MA 02115-3187
(617) 877-7754
(617) 936-4196
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
966
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Y49258
MEDICARE GROUP #
MA
Enumeration date
01/25/2007
Last updated
08/08/2023
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