Provider Demographics
NPI:1467183434
Name:LINDLEY, GREGORY V (BOCO/COPA)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:V
Last Name:LINDLEY
Suffix:
Gender:M
Credentials:BOCO/COPA
Other - Prefix:MR
Other - First Name:GREGORY
Other - Middle Name:V
Other - Last Name:LINDLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:BOCO/COPA
Mailing Address - Street 1:2301 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-4309
Mailing Address - Country:US
Mailing Address - Phone:336-333-9081
Mailing Address - Fax:336-333-9083
Practice Address - Street 1:2301 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-4309
Practice Address - Country:US
Practice Address - Phone:336-333-9081
Practice Address - Fax:336-333-9083
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-21
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC51458222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist