Healthcare Provider Details

I. General information

NPI: 1710070834
Provider Name (Legal Business Name): FREDERICK M GRAFF D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 05/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3009 COLUMBUS ST STE 101
GROVE CITY OH
43123-2763
US

IV. Provider business mailing address

3009 COLUMBUS ST P. O. BOX 577, SUITE 101
GROVE CITY OH
43123-2763
US

V. Phone/Fax

Practice location:
  • Phone: 614-871-8400
  • Fax: 614-871-8897
Mailing address:
  • Phone: 614-871-8400
  • Fax: 614-871-8897

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number1276
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: