Individual
MICHAEL E GREGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3099 NE DIAMOND LAKE BLVD, ROSEBURG, OR 97470-3655
(541) 673-3469
Mailing address
621 W MADRONE ST, ROSEBURG, OR 97470-3090
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201508156LPN
OR
Other
Enumeration date
10/20/2020
Last updated
10/20/2020
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