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General NPI Number Information
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NPI Number | 1083151831
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Entity Type | Organization
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Legal Business Name | GRUBER FAMILY CHIROPRACTIC
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Dates
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Enumeration Date | 01/31/2017
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Last Update Date | 01/31/2017
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Provider Practice Location Address
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Address Line | 20 TECHNOLOGY DR #4
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City | BRATTLEBORO
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State | VT
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Zip | 05301-9181
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Country | US
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Telephone | 802-254-3300
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Fax | 802-254-9068
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Provider Business Mailing Address
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Address Line | 20 TECHNOLOGY DR #4
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City | BRATTLEBORO
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State | VT
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Zip | 05301-9181
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Country | US
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Telephone | 802-254-3300
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Fax | 802-254-9068
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. STEVEN DOUGLAS GRUBER
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Credential | DC
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Telephone | 802-254-3300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 006.0001135
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License Number State | VT
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