Provider Demographics
NPI:1336295179
Name:DYER, GRETCHEN MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:MARIE
Last Name:DYER
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 1:7588 CENTRAL PARKE BLVD
Mailing Address - Street 2:SUITE 326
Mailing Address - City:MASON
Mailing Address - State:OH
Mailing Address - Zip Code:45040-6856
Mailing Address - Country:US
Mailing Address - Phone:513-204-6910
Mailing Address - Fax:513-204-6913
Practice Address - Street 1:7588 CENTRAL PARKE BLVD
Practice Address - Street 2:SUITE 326
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-6856
Practice Address - Country:US
Practice Address - Phone:513-204-6910
Practice Address - Fax:513-204-6913
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3597111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor