Individual
DR. DOUGLAS GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
736 W RIVERDALE ROAD, RIVERDALE, UT 84405-3715
(385) 288-0934
Mailing address
2588 N 500 W, SUNSET, UT 84015-2575
(385) 288-0934
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
10638431-1202
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
82-1177345
FEIN
UT
Enumeration date
01/05/2018
Last updated
06/11/2019
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