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General NPI Number Information
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NPI Number | 1255641601
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Entity Type | Organization
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Legal Business Name | GRIEVES CHIROPRACTIC
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Dates
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Enumeration Date | 10/19/2010
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Last Update Date | 11/29/2024
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Provider Practice Location Address
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Address Line | 116 N MAIN ST
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City | SHAWANO
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State | WI
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Zip | 54166-2356
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Country | US
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Telephone | 715-524-8722
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Fax |
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Provider Business Mailing Address
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Address Line | 116 N MAIN ST
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City | SHAWANO
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State | WI
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Zip | 54166-2356
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BRIAN GRIEVES
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Credential | DC
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Telephone | 715-524-8722
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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 | 3738-012
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License Number State | WI
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