Provider Demographics
NPI:1063703346
Name:GREENSTONE, ERIC BRIAN I (RRT/ CPFT)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:BRIAN
Last Name:GREENSTONE
Suffix:I
Gender:M
Credentials:RRT/ CPFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 584
Mailing Address - Street 2:
Mailing Address - City:TUBA CITY
Mailing Address - State:AZ
Mailing Address - Zip Code:86045-0584
Mailing Address - Country:US
Mailing Address - Phone:928-283-2501
Mailing Address - Fax:
Practice Address - Street 1:167 N. MAIN STREET
Practice Address - Street 2:
Practice Address - City:TUBA CITY
Practice Address - State:AZ
Practice Address - Zip Code:86045-0600
Practice Address - Country:US
Practice Address - Phone:928-283-2501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2011-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2920227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered