Healthcare Provider Details

I. General information

NPI: 1336257930
Provider Name (Legal Business Name): DENISE ELIZABETH GREBER DRAEGER D.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 09/03/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

618 W GREENVILLE RD
N SCITUATE RI
02857-1407
US

IV. Provider business mailing address

PO BOX 595
NORTH SCITUATE RI
02857-0595
US

V. Phone/Fax

Practice location:
  • Phone: 401-647-2550
  • Fax: 401-934-3080
Mailing address:
  • Phone: 401-647-2550
  • Fax: 401-934-3080

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDCP 00342
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: