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General NPI Number Information
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NPI Number | 1093878779
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Entity Type | Organization
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Legal Business Name | GREGORY CHIROPRACTIC HEALTH CENTER P.C.
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Dates
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Enumeration Date | 12/18/2006
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Last Update Date | 11/13/2011
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Provider Practice Location Address
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Address Line | 1114 E MAIN ST SUITE 7
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City | LEBANON
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State | VA
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Zip | 24266-5014
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Country | US
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Telephone | 276-889-4701
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Fax | 276-889-4701
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Provider Business Mailing Address
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Address Line | PO BOX 2425 1114 E MAIN SUITE 7
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City | LEBANON
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State | VA
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Zip | 24266-2425
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Country | US
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Telephone | 276-889-4701
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Fax | 276-889-4701
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BARRY KEITH GREGORY
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Credential | D.C.
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Telephone | 276-889-4701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 0104000589
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License Number State | VA
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