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General NPI Number Information
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NPI Number | 1861520298
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Entity Type | Organization
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Legal Business Name | MICHAEL GRASS
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 10400 DIXIE HWY SUITE 101
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City | LOUISVILLE
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State | KY
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Zip | 40272-3954
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Country | US
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Telephone | 502-933-2005
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Fax | 502-933-2074
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Provider Business Mailing Address
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Address Line | 10400 DIXIE HWY SUITE 101
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City | LOUISVILLE
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State | KY
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Zip | 40272-3954
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Country | US
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Telephone | 502-933-2005
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Fax | 502-933-2074
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Authorized Official
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Title or Position | DOCTOR OF CHIROPRACTIC
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Name | DR. MICHAEL GRASS
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Credential |
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Telephone | 502-254-3442
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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 | 4228
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License Number State | KY
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