Healthcare Provider Details

I. General information

NPI: 1992990642
Provider Name (Legal Business Name): JOHN ALLEN GREEAR CRT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/06/2007
Last Update Date: 09/06/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

852 RIVER RD
LEEDS ME
04263-3130
US

IV. Provider business mailing address

PO BOX 66
LEEDS ME
04263-0066
US

V. Phone/Fax

Practice location:
  • Phone: 207-240-0994
  • Fax:
Mailing address:
  • Phone: 207-240-0994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: