Provider Demographics
NPI:1487787297
Name:MATHENY, GREGORY S (DC)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:S
Last Name:MATHENY
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 1:14738 ARVEY RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:DE
Mailing Address - Zip Code:19956-3068
Mailing Address - Country:US
Mailing Address - Phone:302-875-7202
Mailing Address - Fax:302-846-3255
Practice Address - Street 1:38650 SUSSEX HWY
Practice Address - Street 2:UNIT 9
Practice Address - City:DELMAR
Practice Address - State:DE
Practice Address - Zip Code:19940-3527
Practice Address - Country:US
Practice Address - Phone:302-846-3244
Practice Address - Fax:302-846-3255
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2009-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEF1-0000644111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor