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General NPI Number Information
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NPI Number | 1396969143
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Entity Type | Individual
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Provider Name | WENDY LYNN GRUBER DC
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Gender | Female
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 12/13/2019
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Provider Practice Location Address
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Address Line | 95 MIKEL ST NW
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City | CLEVELAND
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State | TN
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Zip | 37312-5332
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Country | US
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Telephone | 423-476-0023
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Fax | 423-476-3353
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Provider Business Mailing Address
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Address Line | 95 MIKEL ST NW
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City | CLEVELAND
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State | TN
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Zip | 37312-5332
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Country | US
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Telephone | 423-476-0023
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Fax | 423-476-3353
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | DC0000001474
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License Number State | TN
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