Healthcare Provider Details

I. General information

NPI: 1134811151
Provider Name (Legal Business Name): GRANT WEIHRAUCH DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2023
Last Update Date: 05/26/2023
Certification Date: 05/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

768 PARK MEADOW RD
WESTERVILLE OH
43081
US

IV. Provider business mailing address

768 PARK MEADOW RD
WESTERVILLE OH
43081
US

V. Phone/Fax

Practice location:
  • Phone: 614-392-2732
  • Fax: 614-392-2792
Mailing address:
  • Phone: 614-392-2732
  • Fax: 614-392-2792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC-05266
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: