Provider Demographics
NPI:1275525297
Name:PARSONS, GREGORY VEY (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:VEY
Last Name:PARSONS
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 1:411 W HAYCRAFT AVE
Mailing Address - Street 2:STE D-1
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-8105
Mailing Address - Country:US
Mailing Address - Phone:208-765-6804
Mailing Address - Fax:888-338-4609
Practice Address - Street 1:411 W HAYCRAFT AVE
Practice Address - Street 2:STE D-1
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-8105
Practice Address - Country:US
Practice Address - Phone:208-765-6804
Practice Address - Fax:888-338-4609
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-16
Last Update Date:2012-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDCHIA 393111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
C9016OtherBLUE CROSS
006910OtherBLUE SHIELD
C1476OtherBLUE CROSS
000010006910OtherBLUE SHIELD
350042012OtherRAILROAD MEDICARE
50389OtherWA L & I
350042012OtherRAILROAD MEDICARE
T44464Medicare UPIN
50389OtherWA L & I