Provider Demographics
NPI:1023413598
Name:GREER, GARY LEE (LAC)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:LEE
Last Name:GREER
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:PO BOX 4148
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-8148
Mailing Address - Country:US
Mailing Address - Phone:808-391-8028
Mailing Address - Fax:
Practice Address - Street 1:1481 S KING ST
Practice Address - Street 2:SUITE 130
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2601
Practice Address - Country:US
Practice Address - Phone:808-391-8028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-27
Last Update Date:2014-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIACU1066171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist