Organization
GREENLEAF SOFT TISSUE THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARISSA SPENCER (OWNER/MANAGER)
(610) 452-9021
Entity
Organization
Contact information
Practice address
32 MARKET ST, BANGOR, PA 18013-1902
(610) 452-9021
Mailing address
32 MARKET ST, BANGOR, PA 18013-1902
(610) 452-9021
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
208D00000X
General Practice Physician
Primary
—
—
225700000X
Massage Therapist
—
—
Other
Enumeration date
12/30/2020
Last updated
07/12/2021
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