Provider Demographics
NPI:1043458250
Name:FRANKLIN, GREGORY RENAUD (DC)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:RENAUD
Last Name:FRANKLIN
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 1:4010 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-5848
Mailing Address - Country:US
Mailing Address - Phone:803-786-2300
Mailing Address - Fax:803-786-1307
Practice Address - Street 1:4010 MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-5848
Practice Address - Country:US
Practice Address - Phone:803-786-2300
Practice Address - Fax:803-786-1307
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-26
Last Update Date:2009-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2604111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor