Doctor Name: | DR. GREGG ALLEN MEDEIROS |
NPI Number: | 1568545580 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C. |
License Number: | DCP00545 |
Business Practice Address: | 1196 Elmwood Ave Providence, RI - 029073716 |
Business Phone Number: | 4014611600 |
Business Fax Number: | 4014613500 |
Mailing Address: | 43 Mountain Ave, RIVERSIDE |
State: | RI |
Postal Code: | 029155015 |
Phone Number: | 4014404228 |
Fax Number: | |
NPI Enumeration Date: | 10/23/2006 |
NPI Last Update Date: | 05/23/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | DCP00545 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | RI |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |