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General NPI Number Information
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NPI Number | 1790885051
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Entity Type | Individual
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Provider Name | VICTOR GRECO D.C.
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Gender | Male
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Dates
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Enumeration Date | 09/25/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 1860 DULUTH HWY STE. 103
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-5011
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Country | US
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Telephone | 770-962-3473
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Fax | 770-962-3474
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Provider Business Mailing Address
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Address Line | 1000 CHANDLER PARK CT
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-5384
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Country | US
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Telephone | 770-277-9161
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Fax | 770-962-3474
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | CHIR007079
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License Number State | GA
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