Provider Demographics
NPI:1932384104
Name:WILLIAM BURTON GRAY
Entity Type:Organization
Organization Name:WILLIAM BURTON GRAY
Other - Org Name:GREENWOOD CLINIC OF CHIROPRACTIC
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:
Authorized Official - Last Name:HESTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-223-1225
Mailing Address - Street 1:446 GRACE ST
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29649-3125
Mailing Address - Country:US
Mailing Address - Phone:864-223-1225
Mailing Address - Fax:864-223-7346
Practice Address - Street 1:446 GRACE ST
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29649-3125
Practice Address - Country:US
Practice Address - Phone:864-223-1225
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2008-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC0843111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty