Provider Demographics
NPI:1538227988
Name:GREER CHIROPRACTIC LIFE CENTER P. L.L.C.
Entity type:Organization
Organization Name:GREER CHIROPRACTIC LIFE CENTER P. L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:GREER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-451-9700
Mailing Address - Street 1:470 FOREST AVE STE 19
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1739
Mailing Address - Country:US
Mailing Address - Phone:734-451-9700
Mailing Address - Fax:734-451-9723
Practice Address - Street 1:470 FOREST AVE STE 19
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1739
Practice Address - Country:US
Practice Address - Phone:734-451-9700
Practice Address - Fax:734-451-9723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2014-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301005192111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty