Provider Demographics
NPI:1679065114
Name:GREER, ERICK ALLEN JR
Entity type:Individual
Prefix:
First Name:ERICK
Middle Name:ALLEN
Last Name:GREER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:745 SOUTHERN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:UNION SPRINGS
Mailing Address - State:AL
Mailing Address - Zip Code:36089-6643
Mailing Address - Country:US
Mailing Address - Phone:334-738-5590
Mailing Address - Fax:334-738-2460
Practice Address - Street 1:745 SOUTHERN SPRINGS RD
Practice Address - Street 2:
Practice Address - City:UNION SPRINGS
Practice Address - State:AL
Practice Address - Zip Code:36089-6643
Practice Address - Country:US
Practice Address - Phone:334-738-5590
Practice Address - Fax:334-738-2460
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-31
Last Update Date:2018-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1169224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant