Provider Demographics
NPI:1063155687
Name:GRIESE, ALYSIA (DC)
Entity type:Individual
Prefix:DR
First Name:ALYSIA
Middle Name:
Last Name:GRIESE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 E WACKERLY ST
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-7070
Mailing Address - Country:US
Mailing Address - Phone:989-631-5910
Mailing Address - Fax:
Practice Address - Street 1:601 E WACKERLY ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-7070
Practice Address - Country:US
Practice Address - Phone:989-631-5910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-20
Last Update Date:2023-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC4727111N00000X
MI2301401373111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor