Healthcare Provider Details

I. General information

NPI: 1275551053
Provider Name (Legal Business Name): VINCENT EMIL GRECO DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 PEMBROKE STREET
PEMBROKE NH
03275
US

IV. Provider business mailing address

PO BOX 151
PEMBROKE NH
03275
US

V. Phone/Fax

Practice location:
  • Phone: 603-485-3770
  • Fax: 603-485-8834
Mailing address:
  • Phone: 603-485-3770
  • Fax: 603-485-8834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number437A
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: