Provider Demographics
NPI:1285666107
Name:GREER, KELLY (DC)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:GREER
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 1:9797 MONTGOMERY RD STE A
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:OH
Mailing Address - Zip Code:45242-7240
Mailing Address - Country:US
Mailing Address - Phone:513-984-0100
Mailing Address - Fax:513-283-8989
Practice Address - Street 1:9797 MONTGOMERY RD STE A
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:OH
Practice Address - Zip Code:45242-7240
Practice Address - Country:US
Practice Address - Phone:513-984-0100
Practice Address - Fax:513-283-8989
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2017-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3686111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2739675Medicaid
OH2739675Medicaid