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General NPI Number Information
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NPI Number | 1841242088
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Entity Type | Organization
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Legal Business Name | M. GREG MEDLIN, PLC
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Dates
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Enumeration Date | 05/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 115 S MAIN ST
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City | ROCHESTER
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State | MI
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Zip | 48307-2032
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Country | US
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Telephone | 248-330-0457
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Fax |
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Provider Business Mailing Address
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Address Line | 1424 PEBBLE RIDGE DR
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City | ROCHESTER
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State | MI
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Zip | 48307-1769
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Country | US
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Telephone | 248-330-0457
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Fax |
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Authorized Official
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Title or Position | PRESIDENT OWNER OF PRACTICE
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Name | DR. MICHEAL GREGORY MEDLIN
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Credential | D.C.
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Telephone | 248-330-0457
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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 | 2301006169
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License Number State | MI
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