Individual
GREGORY GREELY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11616 SOUTHFORK AVE STE 401, BATON ROUGE, LA 70816
(225) 291-9646
Mailing address
11616 SOUTHFORK AVE STE 401, BATON ROUGE, LA 70816-5241
(225) 291-9646
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/07/2016
Last updated
06/01/2018
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