Healthcare Provider Details

I. General information

NPI: 1821332644
Provider Name (Legal Business Name): G&K GREG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/16/2012
Last Update Date: 11/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 MALABU DR STE 3
LEXINGTON KY
40503-3143
US

IV. Provider business mailing address

121 MALABU DR STE 3
LEXINGTON KY
40503-3143
US

V. Phone/Fax

Practice location:
  • Phone: 859-278-7212
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number
License Number State

VIII. Authorized Official

Name: KATHY GREGORY
Title or Position: OWNER
Credential:
Phone: 859-278-7212