Individual
DR. LEROY ROBERT GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
11216 SUNRISE BLVD E STE 3-203, PUYALLUP, WA 98374-8848
(253) 864-6519
(253) 864-0673
Mailing address
11216 SUNRISE BLVD E STE 3-203, PUYALLUP, WA 98374-8848
(253) 864-6519
(253) 864-0673
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH00003156
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
602020658
UBI
WA
01
—
P00158090
MEDICARE RAILROAD
WA
Enumeration date
11/15/2006
Last updated
09/25/2018
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