Provider Demographics
NPI:1275761702
Name:GRECO, JENNIFER R (DC)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:R
Last Name:GRECO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:97 CLEVELAND DR
Mailing Address - Street 2:
Mailing Address - City:TOWN OF TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14223-1025
Mailing Address - Country:US
Mailing Address - Phone:761-903-1415
Mailing Address - Fax:
Practice Address - Street 1:84 SWEENEY ST
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-5822
Practice Address - Country:US
Practice Address - Phone:716-694-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-23
Last Update Date:2022-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011784111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor