Provider Demographics
NPI:1356097885
Name:HILL, GREGORY LOOMIS (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:LOOMIS
Last Name:HILL
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 1:704 W 11 MILE RD
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-2411
Mailing Address - Country:US
Mailing Address - Phone:248-543-3200
Mailing Address - Fax:248-543-5455
Practice Address - Street 1:704 W 11 MILE RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48067-2411
Practice Address - Country:US
Practice Address - Phone:248-543-3200
Practice Address - Fax:248-543-5455
Is Sole Proprietor?:No
Enumeration Date:2022-02-23
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301401227111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor