Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | CH4353 | FL |
NPI | 1285702001 |
---|---|
Provider Name | Dr. Gregory Charles Priest |
First Address | Dallas, TX 75229-5609 |
Second Address | Dallas, TX 75229-5609 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2006 |
Last Update Date | 27/09/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T55666 | (02) | FL |