MEDICARE: DR. GREGORY GERNES DC

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
1	111N00000X	Chiropractor	6663	MN

General Provider Information

NPI Number	:	1366088395
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREGORY GERNES DC

Provider Business Mailing Address
First Line	:	3311 53RD AVE N APT 106
Second Line	:
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55429-3446
Country	:	US
Telephone Number	:	507-429-2280
Fax Number	:

Provider Business Practice Location Address
First Line	:	3311 53RD AVE N APT 106
Second Line	:
City	:	BROOKLYN CENTER
State	:	MN
Zip	:	55429-3446
Country	:	US
Telephone Number	:	507-429-2280
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/25/2019
Last Update Date	:	11/25/2019

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Directions to “ DR. GREGORY GERNES DC” Practice Location

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