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General NPI Number Information
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NPI Number | 1649460841
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Entity Type | Organization
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Legal Business Name | BRENT R. GRAVES, D.C., INC
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 07/24/2018
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Provider Practice Location Address
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Address Line | 26 W DRY CREEK CIR 640
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City | LITTLETON
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State | CO
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Zip | 80120
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Country | US
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Telephone | 720-306-8280
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Fax | 720-306-8281
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Provider Business Mailing Address
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Address Line | 26 W DRY CREEK CIR 640
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City | LITTLETON
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State | CO
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Zip | 80120-8063
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Country | US
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Telephone | 720-306-8280
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Fax | 720-306-8280
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | CARLA FEY GRAVES
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Credential |
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Telephone | 720-306-8280
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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 | 2344
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License Number State | CO
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