Individual
DR. MICHAEL P GREGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2170 W POINT RD, STE 5, LAGRANGE, GA 30240-4007
(706) 616-6775
Mailing address
2170 W POINT RD, STE 5, LAGRANGE, GA 30240-4007
(706) 616-6775
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIRO02886
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27-2178870
TAX ID
GA
01
—
5248447 001
BLUE CROSS BLUE SHIELD
GA
01
—
CHIR002886
PRACTICE LICENSE
GA
Enumeration date
01/11/2007
Last updated
11/11/2014
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