Provider Demographics
NPI:1912938820
Name:MILLAR, GREGORY BRETT (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:BRETT
Last Name:MILLAR
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:P.O. BOX 21157
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35813-5157
Mailing Address - Country:US
Mailing Address - Phone:256-519-3550
Mailing Address - Fax:256-519-3549
Practice Address - Street 1:2021 CLINTON AVE W STE A
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35805-7111
Practice Address - Country:US
Practice Address - Phone:256-539-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1857111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL511-11529OtherBCBS - DECATUR
AL511-11528OtherBCBS - HUNSTVILLE
AL515-14510OtherBLUE CROSS-MADISON
AL515-92721OtherBCBS - JONES VALLEY
AL515-92721OtherBCBS - JONES VALLEY
AL510I350006Medicare PIN