Provider Demographics
NPI:1730502642
Name:HOGAN, GREG JAMES (D,C)
Entity type:Individual
Prefix:DR
First Name:GREG
Middle Name:JAMES
Last Name:HOGAN
Suffix:
Gender:M
Credentials:D,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:93 DIXON BLVD
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15401-4074
Mailing Address - Country:US
Mailing Address - Phone:724-880-5379
Mailing Address - Fax:
Practice Address - Street 1:1952 STATE ROUTE 66
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-9282
Practice Address - Country:US
Practice Address - Phone:724-834-7882
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-28
Last Update Date:2014-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC010849111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor