MEDICARE: DR. GREGORY JOHN DONNELLY D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	7865	AZ

General Provider Information

NPI Number	:	1295914372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY JOHN DONNELLY D.C.

Provider Business Mailing Address
First Line	:	177 W COTTONWOOD LN STE 11
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-2552
Country	:	US
Telephone Number	:	520-836-0666
Fax Number	:	520-836-9273

Provider Business Practice Location Address
First Line	:	177 W COTTONWOOD LN STE 11
Second Line	:
City	:	CASA GRANDE
State	:	AZ
Zip	:	85122-2552
Country	:	US
Telephone Number	:	520-836-0666
Fax Number	:	520-836-9273

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2007
Last Update Date	:	03/20/2026

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