Individual
DR. SHANA ALEXANDRA GREVEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
2321 WARDS RD, LYNCHBURG, VA 24502-2101
(434) 582-2273
Mailing address
2321 WARDS RD, LYNCHBURG, VA 24502-2101
(434) 582-2273
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
921
IL
207Q00000X
Family Medicine Physician
2012022304
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0102205830
VIRGINIA LICENSE NUMBER
VA
01
—
2012022304
MISSOURI LICENSE NUMBER
MO
Enumeration date
07/04/2012
Last updated
09/10/2019
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