Provider Demographics
NPI:1255384798
Name:MURRAY-GREEN, JAMIE LYNN (DC)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LYNN
Last Name:MURRAY-GREEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1651 POWDER SPRINGS RD SW
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30064-4847
Mailing Address - Country:US
Mailing Address - Phone:770-422-5052
Mailing Address - Fax:770-422-8227
Practice Address - Street 1:1651 POWDER SPRINGS RD SW
Practice Address - Street 2:SUITE 3
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30064-4847
Practice Address - Country:US
Practice Address - Phone:770-422-5052
Practice Address - Fax:770-422-8227
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIROO7157111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAU97155Medicare UPIN
GAGRP6145Medicare ID - Type Unspecified