Provider Demographics
NPI:1184015117
Name:GRIESSE, ROBERT EUGENE (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:EUGENE
Last Name:GRIESSE
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 1:2855 W MARKET ST STE 201
Mailing Address - Street 2:
Mailing Address - City:FAIRLAWN
Mailing Address - State:OH
Mailing Address - Zip Code:44333-4034
Mailing Address - Country:US
Mailing Address - Phone:234-900-4150
Mailing Address - Fax:
Practice Address - Street 1:2855 W MARKET ST STE 201
Practice Address - Street 2:
Practice Address - City:FAIRLAWN
Practice Address - State:OH
Practice Address - Zip Code:44333-4034
Practice Address - Country:US
Practice Address - Phone:234-900-4150
Practice Address - Fax:234-900-4151
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4504111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor