Provider Demographics
NPI:1184689135
Name:MUCHNIJ, GREG P X (CH)
Entity Type:Individual
Prefix:DR
First Name:GREG
Middle Name:P
Last Name:MUCHNIJ
Suffix:X
Gender:M
Credentials:CH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4550 E BELL RD STE 284
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-9384
Mailing Address - Country:US
Mailing Address - Phone:602-866-3505
Mailing Address - Fax:608-866-2521
Practice Address - Street 1:4550 E BELL RD
Practice Address - Street 2:STE.284
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-9306
Practice Address - Country:US
Practice Address - Phone:602-866-3505
Practice Address - Fax:602-866-2521
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2008-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ118228111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ118229OtherGROUP UPIN
AZ1114116936OtherGROUP NPI
AZ118228Medicare UPIN