Provider Demographics
NPI:1033242276
Name:LING, GREGORY SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:SCOTT
Last Name:LING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 FULTON ST.
Mailing Address - Street 2:SUITE A
Mailing Address - City:GRAND HAVEN
Mailing Address - State:MI
Mailing Address - Zip Code:49417
Mailing Address - Country:US
Mailing Address - Phone:616-844-1416
Mailing Address - Fax:616-844-1426
Practice Address - Street 1:700 FULTON ST.
Practice Address - Street 2:SUITE A
Practice Address - City:GRAND HAVEN
Practice Address - State:MI
Practice Address - Zip Code:49417
Practice Address - Country:US
Practice Address - Phone:616-844-1416
Practice Address - Fax:616-844-1426
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301007502111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIGL007502OtherBCBS
MIP95513OtherBCN
MIP95513OtherBCN