Individual
DR. DARRYL DODD GREGERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2518 E KENOSHA ST, BROKEN ARROW, OK 74014-6712
(918) 286-2729
(918) 286-0651
Mailing address
2518 E KENOSHA ST, BROKEN ARROW, OK 74014-6712
(918) 286-2729
(918) 286-0651
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3878
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2118786
—
IA
01
—
46813
BLUE CROSS/BLUE SHIELD
IA
Enumeration date
08/19/2006
Last updated
07/22/2008
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