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General NPI Number Information
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NPI Number | 1144419474
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Entity Type | Organization
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Legal Business Name | ERIC A GRAVES INC
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Dates
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Enumeration Date | 10/23/2007
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Last Update Date | 09/19/2008
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Provider Practice Location Address
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Address Line | 4257 MAIN STREET SUITE 210
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City | WESTMINSTER
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State | CO
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Zip | 80031-0000
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Country | US
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Telephone | 303-635-0211
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Fax | 303-469-1116
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Provider Business Mailing Address
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Address Line | 4257 MAIN STREET SUITE 210
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City | WESTMINSTER
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State | CO
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Zip | 80031
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Country | US
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Telephone | 303-635-0211
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Fax | 303-469-1116
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Authorized Official
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Title or Position | OWNER
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Name | DR. ERIC ANTHONY GRAVES
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Credential | DC
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Telephone | 303-635-0211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 4525
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License Number State | CO
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