Provider Demographics
NPI:1932348067
Name:JUSTICE, GREGORY (DC)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:
Last Name:JUSTICE
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 1:9075 FORSSTROM DR
Mailing Address - Street 2:
Mailing Address - City:LONETREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-6737
Mailing Address - Country:US
Mailing Address - Phone:303-470-1995
Mailing Address - Fax:303-346-7628
Practice Address - Street 1:9075 FORSSTROM DR
Practice Address - Street 2:
Practice Address - City:LONETREE
Practice Address - State:CO
Practice Address - Zip Code:80124-6737
Practice Address - Country:US
Practice Address - Phone:303-470-1995
Practice Address - Fax:303-346-7628
Is Sole Proprietor?:No
Enumeration Date:2009-02-12
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4827111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor