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General NPI Number Information
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NPI Number | 1528104668
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Entity Type | Organization
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Legal Business Name | GREGORY W PURSLEY DC LLC
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 04/15/2015
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Provider Practice Location Address
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Address Line | 5 DOCTORS PARK
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63703-4927
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Country | US
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Telephone | 573-335-9188
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Fax | 573-335-1838
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Provider Business Mailing Address
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Address Line | 5 DOCTORS PARK
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City | CAPE GIRARDEAU
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State | MO
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Zip | 63703-4927
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Country | US
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Telephone | 573-335-9188
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Fax | 573-335-1838
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Authorized Official
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Title or Position | OWNER
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Name | DR. GREG W PURSLEY
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Credential | D.C.
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Telephone | 573-335-9188
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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 | 2006035611
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License Number State | MO
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