Provider Demographics
NPI:1326056938
Name:GREER, JEFFREY WAYNE (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:WAYNE
Last Name:GREER
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 1:245 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1238
Mailing Address - Country:US
Mailing Address - Phone:734-451-9700
Mailing Address - Fax:734-451-9723
Practice Address - Street 1:245 N MAIN ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1238
Practice Address - Country:US
Practice Address - Phone:734-451-9700
Practice Address - Fax:734-451-9723
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2018-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005192111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
350047269OtherRAILROAD RET, PROV. I.D.
MI0H25111OtherBC/BS PROVIDER IDENT. #
MIU23022Medicare UPIN