Individual
DR. BEAU ANTHONY GREGERSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C
Contact information
Practice address
330 W 58TH ST, SUITE# 407, NEW YORK, NY 10019-1827
(212) 765-6470
(212) 333-7346
Mailing address
330 W 58TH ST, SUITE# 407, NEW YORK, NY 10019-1827
(212) 765-6470
(212) 333-7346
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
10129
TX
111N00000X
Chiropractor
X011304-1
NY
Other
Enumeration date
02/05/2007
Last updated
09/25/2012
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