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General NPI Number Information
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NPI Number | 1669499356
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Entity Type | Organization
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Legal Business Name | LAWRENCE A GRALEWSKI
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2178 FORT ST
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City | LINCOLN PARK
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State | MI
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Zip | 48146-2405
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Country | US
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Telephone | 313-383-7227
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Fax | 313-383-7295
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Provider Business Mailing Address
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Address Line | 48635 CRESCENT DR
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City | MACOMB
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State | MI
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Zip | 48044-2117
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Country | US
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Telephone | 586-949-3799
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Fax | 313-383-7295
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Authorized Official
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Title or Position | PROVIDER
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Name | LAWRENCE A GRALEWSKI
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Credential | DC
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Telephone | 313-383-7227
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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 | LG005027
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License Number State | MI
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