Provider Demographics
NPI:1982762019
Name:LAGREE, JEFFREY E (DC)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:E
Last Name:LAGREE
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 1:4201 GLEN FOREST DR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-6101
Mailing Address - Country:US
Mailing Address - Phone:502-216-4699
Mailing Address - Fax:
Practice Address - Street 1:4201 GLEN FOREST DR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-6101
Practice Address - Country:US
Practice Address - Phone:502-216-4699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2016-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4071111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000478983OtherANTHEM