Provider Demographics
NPI:1639481567
Name:GREEP, KENNETH C (LAC)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:C
Last Name:GREEP
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:657 CHERRY TREE LN
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-8947
Mailing Address - Country:US
Mailing Address - Phone:724-557-6533
Mailing Address - Fax:
Practice Address - Street 1:657 CHERRY TREE LN
Practice Address - Street 2:
Practice Address - City:UNIONTOWN
Practice Address - State:PA
Practice Address - Zip Code:15401-8947
Practice Address - Country:US
Practice Address - Phone:724-557-6533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-08
Last Update Date:2023-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA000330171100000X
TXAC01182171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist