Healthcare Provider Details

I. General information

NPI: 1568588358
Provider Name (Legal Business Name): GREGORY JOSEPH KAMEGO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

716 N VAN DYKE RD
ALMONT MI
48003-8500
US

IV. Provider business mailing address

716 N VAN DYKE RD
ALMONT MI
48003-8500
US

V. Phone/Fax

Practice location:
  • Phone: 810-798-7500
  • Fax: 810-798-7577
Mailing address:
  • Phone: 810-798-7500
  • Fax: 810-798-7577

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301007909
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: