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General NPI Number Information
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NPI Number | 1659948917
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Entity Type | Individual
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Provider Name | GRANT SPEER
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Gender | Male
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Dates
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Enumeration Date | 06/07/2021
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Last Update Date | 06/07/2021
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Provider Practice Location Address
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Address Line | 956 RUSTLEWOOD LN
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City | SAINT JOHNS
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State | FL
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Zip | 32259-5950
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Country | US
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Telephone | 217-273-2098
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Fax |
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Provider Business Mailing Address
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Address Line | 185 DURBIN STATION CT SUITE 802
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City | SAINT JOHNS
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State | FL
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Zip | 32259
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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 |
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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 | 13527
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | CH13527
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License Number State | FL
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