Provider Demographics
NPI:1134189756
Name:HARBERS, GREGORY J (DC)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:J
Last Name:HARBERS
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 1:58 N US HIGHWAY 17/92
Mailing Address - Street 2:SUITE B
Mailing Address - City:DEBARY
Mailing Address - State:FL
Mailing Address - Zip Code:32713-2507
Mailing Address - Country:US
Mailing Address - Phone:386-668-6321
Mailing Address - Fax:386-668-1855
Practice Address - Street 1:58 N US HIGHWAY 17/92
Practice Address - Street 2:SUITE B
Practice Address - City:DEBARY
Practice Address - State:FL
Practice Address - Zip Code:32713-2507
Practice Address - Country:US
Practice Address - Phone:386-668-6321
Practice Address - Fax:386-668-1855
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003194111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL70189Medicare ID - Type Unspecified