Healthcare Provider Details
I. General information
NPI: 1730267170
Provider Name (Legal Business Name): GREGORY GENE VRONA D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/02/2006
Last Update Date: 02/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
13 KILBURN ST
BURLINGTON VT
05401-4750
US
IV. Provider business mailing address
50 KILLARNEY DR
BURLINGTON VT
05408-2702
US
V. Phone/Fax
- Phone: 802-777-1138
- Fax: 404-299-9635
- Phone: 802-777-1138
- Fax: 404-299-9635
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | CHIR006646 |
| License Number State | GA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 006.0075459 |
| License Number State | VT |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: