Individual
DR. MARK THOMAS GRIESEMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
223 S STATE ROAD 135, GREENWOOD, IN 46142-1421
(317) 881-9792
(317) 882-1766
Mailing address
223 S STATE ROAD 135, GREENWOOD, IN 46142-1421
(317) 881-9792
(317) 882-1766
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001713A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000207597
ANTHEM PIN
IN
05
—
200223900
—
IN
01
—
7165004
AETNA PIN
IN
Enumeration date
04/21/2006
Last updated
07/25/2011
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