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NPI Code Detail

MEDICARE: MR. GARRETT A GREGG LSW

MEDICARE: MR. GARRETT A GREGG LSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial WorkerS.2004971OH

General Provider Information

NPI Number : 1063175792
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. GARRETT A GREGG LSW
Provider Business Mailing Address
First Line : 343 S CRESTLINE BLOOMINGGROVE RD
Second Line :
City : GALION
State : OH
Zip : 44833-9551
Country : US
Telephone Number : 567-215-6787
Fax Number :
Provider Business Practice Location Address
First Line : 1065 MEDINA RD
Second Line :
City : MEDINA
State : OH
Zip : 44256-5375
Country : US
Telephone Number : 614-844-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/19/2021
Last Update Date : 06/30/2023

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Directions to “ MR. GARRETT A GREGG LSW” Practice Location

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