| Doctor Name: | HARLEY GREGORY |
| NPI Number: | 1154730356 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 109 Prospect St North Fairfield, OH - 448559550 |
| Business Phone Number: | 4195777896 |
| Business Fax Number: | |
| Mailing Address: | 109 Prospect St, NORTH FAIRFIELD |
| State: | OH |
| Postal Code: | 448559550 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 08/13/2014 |
| NPI Last Update Date: | 08/13/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171WH0202X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Contractor |
| Taxonomy Specialization: | Home Modifications |
| Taxonomy Definition: | |