Provider Demographics
NPI:1154466910
Name:KROWN, GREGORY J (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:J
Last Name:KROWN
Suffix:
Gender:M
Credentials:DC
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Mailing Address - Street 1:145 N MARIETTA PKWY NE
Mailing Address - Street 2:SUITE D
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-8023
Mailing Address - Country:US
Mailing Address - Phone:770-426-9707
Mailing Address - Fax:770-426-1974
Practice Address - Street 1:145 N MARIETTA PKWY NE
Practice Address - Street 2:SUITE D
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-8023
Practice Address - Country:US
Practice Address - Phone:770-426-9707
Practice Address - Fax:770-426-1974
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GACHIR006232111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA618978OtherUNITED HEALTHCARE
GA618978OtherUNITED HEALTHCARE
GA35ZCFZNMedicare ID - Type Unspecified