Provider Demographics
NPI:1447647680
Name:GREELEY CHIROPRACTIC AND MASSAGE
Entity type:Organization
Organization Name:GREELEY CHIROPRACTIC AND MASSAGE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF CHIROPRACTIC/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:GREELEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:724-387-8215
Mailing Address - Street 1:4028 WILLIAM PENN HWY
Mailing Address - Street 2:
Mailing Address - City:MURRYSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15668-1806
Mailing Address - Country:US
Mailing Address - Phone:724-387-8215
Mailing Address - Fax:724-387-8224
Practice Address - Street 1:4028 WILLIAM PENN HWY
Practice Address - Street 2:
Practice Address - City:MURRYSVILLE
Practice Address - State:PA
Practice Address - Zip Code:15668-1806
Practice Address - Country:US
Practice Address - Phone:724-387-8215
Practice Address - Fax:724-387-8224
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-24
Last Update Date:2015-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009073111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty