Healthcare Provider Details

I. General information

NPI: 1164761128
Provider Name (Legal Business Name): GRANT ELMER HRABOVSKY D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2013
Last Update Date: 10/14/2021
Certification Date: 10/14/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5770 BUTLER ST
PITTSBURGH PA
15201-2116
US

IV. Provider business mailing address

5770 BUTLER ST
PITTSBURGH PA
15201-2116
US

V. Phone/Fax

Practice location:
  • Phone: 412-708-3887
  • Fax: 412-774-1842
Mailing address:
  • Phone: 412-708-3887
  • Fax: 412-774-1842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberDC010681
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: