Provider Demographics
NPI:1992845390
Name:DENUNZIO, GREGORY SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:SCOTT
Last Name:DENUNZIO
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 1:14501 GRANADA DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:APPLE VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55124-6315
Mailing Address - Country:US
Mailing Address - Phone:952-431-3003
Mailing Address - Fax:952-431-6448
Practice Address - Street 1:1079 PINE ISLE LN # 1079
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-6182
Practice Address - Country:US
Practice Address - Phone:952-431-3003
Practice Address - Fax:952-431-6448
Is Sole Proprietor?:No
Enumeration Date:2007-02-07
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4145111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNU55426Medicare UPIN
MN350003043Medicare ID - Type UnspecifiedPROVIDER NUMBER