Healthcare Provider Details

I. General information

NPI: 1417863978
Provider Name (Legal Business Name): GRANT FOX
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 OAKRIDGE DR UNIT 113
FORT COLLINS CO
80525-6242
US

IV. Provider business mailing address

4701 STRAUSS CABIN RD APT 2209
FORT COLLINS CO
80528-4647
US

V. Phone/Fax

Practice location:
  • Phone: 970-226-6556
  • Fax:
Mailing address:
  • Phone: 224-430-9735
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCHR.0009058
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: