Healthcare Provider Details

I. General information

NPI: 1679634695
Provider Name (Legal Business Name): JAMES J. GRANETO D.C., F.A.C.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7291 WEST BLVD
YOUNGSTOWN OH
44512-7317
US

IV. Provider business mailing address

7291 WEST BLVD
YOUNGSTOWN OH
44512-7317
US

V. Phone/Fax

Practice location:
  • Phone: 330-758-5119
  • Fax: 330-758-5195
Mailing address:
  • Phone: 330-758-5119
  • Fax: 330-758-5195

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number762
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number645
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: