Provider Demographics
NPI:1386778058
Name:GREENLEE, JAMES M (DC)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:M
Last Name:GREENLEE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3720 GRASS VALLEY HWY
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:CA
Mailing Address - Zip Code:95602-2002
Mailing Address - Country:US
Mailing Address - Phone:530-885-2909
Mailing Address - Fax:530-885-1421
Practice Address - Street 1:3720 GRASS VALLEY HWY
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:CA
Practice Address - Zip Code:95602-2002
Practice Address - Country:US
Practice Address - Phone:530-885-2909
Practice Address - Fax:530-885-1421
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA12182111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0121820Medicare ID - Type UnspecifiedCHIROPRACTIC
CAT04658Medicare UPIN