Doctor Name: | DR. GREGORY K TILLEY |
NPI Number: | 1922141456 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C. |
License Number: | 010400184 |
Business Practice Address: | 825 Davis St Suite B Blacksburg, VA - 240607013 |
Business Phone Number: | 5409511183 |
Business Fax Number: | 5409511138 |
Mailing Address: | 825 Davis St, Suite B BLACKSBURG |
State: | VA |
Postal Code: | 240607013 |
Phone Number: | 5409511183 |
Fax Number: | 5409511138 |
NPI Enumeration Date: | 02/15/2007 |
NPI Last Update Date: | 02/16/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | 010400184 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
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. |