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General NPI Number Information
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NPI Number | 1093426462
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Entity Type | Organization
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Legal Business Name | GRANITE FAMILY CHIROPRACTIC CENTER, PC
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Dates
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Enumeration Date | 12/07/2022
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Last Update Date | 02/03/2023
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Provider Practice Location Address
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Address Line | 868 PRENTICE ST
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City | GRANITE FALLS
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State | MN
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Zip | 56241-1521
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Country | US
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Telephone | 320-564-1209
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Fax | 320-564-1210
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Provider Business Mailing Address
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Address Line | PO BOX 93
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City | GRANITE FALLS
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State | MN
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Zip | 56241-0093
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Country | US
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Telephone | 320-564-1209
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Fax | 320-564-1210
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Authorized Official
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Title or Position | OWNER/CHIROPRACTOR
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Name | DR. ANN E EGGEBRAATEN
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Credential | DC
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Telephone | 507-227-0542
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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 |
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License Number State |
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