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NPI Code Detail

MEDICARE: GRANDVIEW MEDICAL PROFESSIONAL CORPORATION

MEDICARE: GRANDVIEW MEDICAL PROFESSIONAL CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1111NR0400XRehabilitation Chiropractor

General Provider Information

NPI Number : 1134342710
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRANDVIEW MEDICAL PROFESSIONAL CORPORATION
Provider Business Mailing Address
First Line : 1378 GRANDVIEW AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43212-2803
Country : US
Telephone Number : 614-488-2225
Fax Number : 614-488-2229
Provider Business Practice Location Address
First Line : 1378 GRANDVIEW AVE
Second Line :
City : COLUMBUS
State : OH
Zip : 43212-2803
Country : US
Telephone Number : 614-488-2225
Fax Number : 614-488-2229
Authorized Official
Title or Position : OFFICE MANAGER
Name : MISS CARRIE LYNN KNICK
Credential : L.M.T.
Telephone Number : 614-488-2225
Provider Enumeration Date : 04/11/2007
Last Update Date : 09/05/2007

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Directions to “GRANDVIEW MEDICAL PROFESSIONAL CORPORATION ” Practice Location

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