Provider Demographics
NPI:1275551053
Name:GRECO, VINCENT EMIL (DC)
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:EMIL
Last Name:GRECO
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:PO BOX 151
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:NH
Mailing Address - Zip Code:03275
Mailing Address - Country:US
Mailing Address - Phone:603-485-3770
Mailing Address - Fax:603-485-8834
Practice Address - Street 1:210 PEMBROKE STREET
Practice Address - Street 2:
Practice Address - City:PEMBROKE
Practice Address - State:NH
Practice Address - Zip Code:03275
Practice Address - Country:US
Practice Address - Phone:603-485-3770
Practice Address - Fax:603-485-8834
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH437A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH2177OtherCIGNA
NH0508477Y0NH01OtherBC
NH0508477Y0NH01OtherBC