Provider Demographics
NPI:1124457932
Name:JEAN-PIERRE, GREGORY E (DC)
Entity type:Individual
Prefix:
First Name:GREGORY
Middle Name:E
Last Name:JEAN-PIERRE
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 1:190 NE 128TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33161-4514
Mailing Address - Country:US
Mailing Address - Phone:786-253-9249
Mailing Address - Fax:
Practice Address - Street 1:7301A W PALMETTO PARK RD
Practice Address - Street 2:SUITE 304B
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33433-3409
Practice Address - Country:US
Practice Address - Phone:561-231-0109
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-03
Last Update Date:2013-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH 10049111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor