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General NPI Number Information
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NPI Number | 1649658006
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Entity Type | Organization
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Legal Business Name | GROSMAN CHIROPRACTIC CLINIC PLLC
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Dates
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Enumeration Date | 05/18/2015
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 5410 W FRIENDLY AVE
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City | GREENSBORO
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State | NC
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Zip | 27410-4210
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Country | US
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Telephone | 336-292-9779
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Fax | 336-292-9953
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Provider Business Mailing Address
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Address Line | 5410 W FRIENDLY AVE
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City | GREENSBORO
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State | NC
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Zip | 27410-4210
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Country | US
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Telephone | 336-292-9779
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Fax | 336-292-9953
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Authorized Official
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Title or Position | OWNER
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Name | DR. LARRY W GROSMAN
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Credential | DC
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Telephone | 336-292-9779
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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 | 924
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License Number State | NC
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