MEDICARE: KATIE GRECH D.C., P.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

General Provider Information

NPI Number	:	1740813567
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KATIE GRECH D.C., P.C.

Provider Business Mailing Address
First Line	:	1147 E LONG LAKE RD STE 3
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48085-4943
Country	:	US
Telephone Number	:	248-524-2223
Fax Number	:	248-524-1398

Provider Business Practice Location Address
First Line	:	1147 E LONG LAKE RD STE 3
Second Line	:
City	:	TROY
State	:	MI
Zip	:	48085-4943
Country	:	US
Telephone Number	:	248-524-2223
Fax Number	:	248-524-1398

Authorized Official
Title or Position	:	OWNER
Name	:	KATIE CHERIE GRECH
Credential	:	D.C.
Telephone Number	:	248-524-2223

Provider Enumeration Date	:	02/20/2020
Last Update Date	:	02/20/2020

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