Provider Demographics
NPI:1013061191
Name:LOMAN, GREG (DC)
Entity Type:Individual
Prefix:
First Name:GREG
Middle Name:
Last Name:LOMAN
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 1:2515 NORTHBROOKE PLAZA DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34119-8088
Mailing Address - Country:US
Mailing Address - Phone:239-597-6099
Mailing Address - Fax:239-597-6987
Practice Address - Street 1:2515 NORTHBROOKE PLAZA DR
Practice Address - Street 2:SUITE 102
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34119-8088
Practice Address - Country:US
Practice Address - Phone:239-597-6099
Practice Address - Fax:239-597-6987
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0006336111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL22685OtherBLUE CROSS BLUE SHEILD