Provider Demographics
NPI:1336257930
Name:GREBER DRAEGER, DENISE ELIZABETH (DC)
Entity Type:Individual
Prefix:DR
First Name:DENISE
Middle Name:ELIZABETH
Last Name:GREBER DRAEGER
Suffix:
Gender:F
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:PO BOX 595
Mailing Address - Street 2:
Mailing Address - City:NORTH SCITUATE
Mailing Address - State:RI
Mailing Address - Zip Code:02857-0595
Mailing Address - Country:US
Mailing Address - Phone:401-647-2550
Mailing Address - Fax:401-934-3080
Practice Address - Street 1:618 W GREENVILLE RD
Practice Address - Street 2:
Practice Address - City:N SCITUATE
Practice Address - State:RI
Practice Address - Zip Code:02857-1407
Practice Address - Country:US
Practice Address - Phone:401-647-2550
Practice Address - Fax:401-934-3080
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP 00342111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI4408475OtherATNEA
RI9163-3OtherBLUE CROSS
RI350105OtherHARVARD PILGRIM
RI646617OtherACN
RI720080401OtherCIGNA
RI401984OtherBLUE CHIP
RI44-00078OtherBLUE CROSS
RI774362OtherTUFTS
RI44-00078OtherBLUE CROSS
RI9163-3OtherBLUE CROSS