Provider Demographics
NPI:1063910792
Name:GREGORY, VICTORIA (DC, MS)
Entity type:Individual
Prefix:DR
First Name:VICTORIA
Middle Name:
Last Name:GREGORY
Suffix:
Gender:
Credentials:DC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 MEADOW AVE
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47933-2718
Mailing Address - Country:US
Mailing Address - Phone:765-376-6021
Mailing Address - Fax:
Practice Address - Street 1:409 MEADOW AVE
Practice Address - Street 2:
Practice Address - City:CRAWFORDSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47933-2718
Practice Address - Country:US
Practice Address - Phone:765-376-6021
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-29
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08003014A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor