Healthcare Provider Details

I. General information

NPI: 1821148057
Provider Name (Legal Business Name): DAVID GREYDINGER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2007
Last Update Date: 04/25/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5913 S CONGRESS AVE
ATLANTIS FL
33462-1303
US

IV. Provider business mailing address

240 188TH ST
SUNNY ISLES BEACH FL
33160-2436
US

V. Phone/Fax

Practice location:
  • Phone: 561-296-5243
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCH9091
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number009225
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: