Provider Demographics
NPI:1447319694
Name:GREGORY, MEGHAN (DC)
Entity type:Individual
Prefix:
First Name:MEGHAN
Middle Name:
Last Name:GREGORY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:644 CLARK DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:NC
Mailing Address - Zip Code:28092-3714
Mailing Address - Country:US
Mailing Address - Phone:704-735-9668
Mailing Address - Fax:704-735-9775
Practice Address - Street 1:644 CLARK DR
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:NC
Practice Address - Zip Code:28092-3714
Practice Address - Country:US
Practice Address - Phone:704-735-9668
Practice Address - Fax:704-735-9775
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2161111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC890859EMedicaid
NCU46031Medicare UPIN
NC2454788Medicare ID - Type Unspecified