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General NPI Number Information
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NPI Number | 1558510818
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Entity Type | Individual
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Provider Name | JONATHAN GRAND D.C
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Gender | Male
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Dates
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Enumeration Date | 09/11/2008
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Last Update Date | 11/03/2016
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Provider Practice Location Address
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Address Line | 3111 45TH ST STE 5
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City | WEST PALM BEACH
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State | FL
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Zip | 33407-1981
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Country | US
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Telephone | 561-530-4655
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Fax | 561-530-4689
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Provider Business Mailing Address
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Address Line | PO BOX 16836
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City | WEST PALM BEACH
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State | FL
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Zip | 33416-6836
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Country | US
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Telephone | 561-797-3345
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Fax |
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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 | CH9392
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License Number State | FL
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