Provider Demographics
NPI:1821432675
Name:OFFICES OF DR. BARBARA ONEDERA-GREGORY & DR. ROBERT W. GREGORY, P.C.
Entity Type:Organization
Organization Name:OFFICES OF DR. BARBARA ONEDERA-GREGORY & DR. ROBERT W. GREGORY, P.C.
Other - Org Name:PACIFIC LIFE CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CORPORATE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:J O
Authorized Official - Last Name:GREGORY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:671-649-9355
Mailing Address - Street 1:744 N MARINE CORPS DR STE 110
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913-4426
Mailing Address - Country:US
Mailing Address - Phone:671-649-9355
Mailing Address - Fax:671-649-9255
Practice Address - Street 1:744 N MARINE CORPS DR STE 110
Practice Address - Street 2:
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-4426
Practice Address - Country:US
Practice Address - Phone:671-649-9355
Practice Address - Fax:671-649-9255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-24
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUC-007111N00000X
GUC-00011111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty