Provider Demographics
NPI:1750657086
Name:GREGORY, BRITTANY MARIE (DC)
Entity Type:Individual
Prefix:DR
First Name:BRITTANY
Middle Name:MARIE
Last Name:GREGORY
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 1:135 E SUPERIOR ST
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49348-1137
Mailing Address - Country:US
Mailing Address - Phone:269-876-7814
Mailing Address - Fax:
Practice Address - Street 1:135 E SUPERIOR ST
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MI
Practice Address - Zip Code:49348-1137
Practice Address - Country:US
Practice Address - Phone:269-876-7814
Practice Address - Fax:269-792-6459
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-30
Last Update Date:2012-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038.012160111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor