Provider Demographics
NPI:1134226103
Name:HURON, GREGORY MICHAEL (DC)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:MICHAEL
Last Name:HURON
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 1:3864 COURTNEY ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18017-8987
Mailing Address - Country:US
Mailing Address - Phone:610-691-4444
Mailing Address - Fax:610-691-4455
Practice Address - Street 1:3864 COURTNEY ST
Practice Address - Street 2:SUITE 150
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-8987
Practice Address - Country:US
Practice Address - Phone:610-691-4444
Practice Address - Fax:610-691-4455
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC005305L111N00000X
PAAJ-005305-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU60926Medicare UPIN
PA837241Medicare ID - Type Unspecified