Provider Demographics
NPI:1053549683
Name:GREGORY A JUSTICE DC, PC
Entity type:Organization
Organization Name:GREGORY A JUSTICE DC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:ALLEN
Authorized Official - Last Name:JUSTICE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:303-470-1995
Mailing Address - Street 1:9075 FORSSTROM DR
Mailing Address - Street 2:
Mailing Address - City:LONETREE
Mailing Address - State:CO
Mailing Address - Zip Code:80124-6737
Mailing Address - Country:US
Mailing Address - Phone:303-470-1995
Mailing Address - Fax:303-346-7628
Practice Address - Street 1:9075 FORSSTROM DR
Practice Address - Street 2:
Practice Address - City:LONETREE
Practice Address - State:CO
Practice Address - Zip Code:80124-6737
Practice Address - Country:US
Practice Address - Phone:303-470-1995
Practice Address - Fax:303-346-7628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-22
Last Update Date:2012-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4827111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty