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General NPI Number Information
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NPI Number | 1205004736
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Entity Type | Organization
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Legal Business Name | AMERICAN HEALTH CENTERS OF GRAYSON, INC
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Dates
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Enumeration Date | 02/19/2008
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Last Update Date | 02/19/2008
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Provider Practice Location Address
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Address Line | 186 INTERSTATE DR
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City | GRAYSON
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State | KY
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Zip | 41143-1787
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Country | US
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Telephone | 740-646-7321
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Fax |
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Provider Business Mailing Address
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Address Line | 103 THELMA AVE
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City | SOUTH POINT
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State | OH
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Zip | 45680-9203
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Country | US
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Telephone | 740-646-7321
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Fax |
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Authorized Official
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Title or Position | BILLING MANAGER
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Name | MRS. HOLLY DAWN LAWSON
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Credential |
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Telephone | 740-646-7321
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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 | 4440
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License Number State | KY
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