Provider Demographics
NPI:1417971219
Name:SCHWARTZENBERGER, GREG (DC)
Entity Type:Individual
Prefix:DR
First Name:GREG
Middle Name:
Last Name:SCHWARTZENBERGER
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 1:8673 FIELDS ERTEL RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45249-8269
Mailing Address - Country:US
Mailing Address - Phone:513-469-6688
Mailing Address - Fax:513-469-6686
Practice Address - Street 1:8673 FIELDS ERTEL RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-8269
Practice Address - Country:US
Practice Address - Phone:513-469-6688
Practice Address - Fax:513-469-6686
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2009-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2421111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5879350001OtherMEDICARE DME
OH2043845Medicaid
OH5879350001Medicare NSC
OH2043845Medicaid
OH0842911Medicare PIN