Provider Demographics
NPI:1962128181
Name:GREENWOOD, MARCELUS ALMANDO (DC)
Entity type:Individual
Prefix:
First Name:MARCELUS
Middle Name:ALMANDO
Last Name:GREENWOOD
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 1:13538 LARSEN LN
Mailing Address - Street 2:
Mailing Address - City:WINTER GARDEN
Mailing Address - State:FL
Mailing Address - Zip Code:34787-5010
Mailing Address - Country:US
Mailing Address - Phone:407-227-7466
Mailing Address - Fax:
Practice Address - Street 1:13538 LARSEN LN
Practice Address - Street 2:
Practice Address - City:WINTER GARDEN
Practice Address - State:FL
Practice Address - Zip Code:34787-5010
Practice Address - Country:US
Practice Address - Phone:407-227-7466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH13260111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor