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General NPI Number Information
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NPI Number | 1821287731
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Entity Type | Organization
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Legal Business Name | COOL CREEK CHIROPRACTIC LLC
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 05/14/2014
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Provider Practice Location Address
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Address Line | 14747 OAK ROAD BLD 3 SUITE 300
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City | CARMEL
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State | IN
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Zip | 46033
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Country | US
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Telephone | 317-818-1414
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Fax |
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Provider Business Mailing Address
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Address Line | 14747 OAK RD SUITE 300
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City | CARMEL
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State | IN
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Zip | 46033-8183
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Country | US
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Telephone | 317-818-1414
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Fax | 317-818-1014
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Authorized Official
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Title or Position | MEMBER
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Name | DR. GRANT ROMINE
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Credential | D.C.
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Telephone | 317-818-1414
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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 | 08002343A
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License Number State | IN
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