Individual
GREGORY WILLIAM GEORGIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2595 N MULFORD RD, ROCKFORD, IL 61114-5643
(815) 904-6000
Mailing address
2595 N MULFORD RD, ROCKFORD, IL 61114-5643
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
133N00000X
Nutritionist
—
—
Other
Enumeration date
02/17/2016
Last updated
02/26/2016
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