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General NPI Number Information
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NPI Number | 1881219111
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Entity Type | Organization
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Legal Business Name | GROVE CHIROPRACTIC LLC
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Dates
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Enumeration Date | 06/12/2020
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Last Update Date | 06/12/2020
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Provider Practice Location Address
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Address Line | 1236 GROVE RD
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City | PITTSBURGH
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State | PA
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Zip | 15234-2311
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Country | US
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Telephone | 412-952-2336
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Fax |
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Provider Business Mailing Address
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Address Line | 1674 HASTINGS MILL RD
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City | PITTSBURGH
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State | PA
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Zip | 15241-2862
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Country | US
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Telephone | 412-257-8090
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Fax | 412-257-8121
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Authorized Official
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Title or Position | OWNER
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Name | DR. GEORGE E FRAUDIN JR.
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Credential | DC
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Telephone | 412-952-2336
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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 |
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License Number State |
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