MEDICARE: DR. LORI ANN GRILLO D.C.

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
1	111N00000X	Chiropractor	1427	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	641668	OTHER	TN	UNITED HEALTHCARE
3	4111606	OTHER	TN	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1346214566
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORI ANN GRILLO D.C.

Provider Business Mailing Address
First Line	:	442 E MAIN ST
Second Line	:
City	:	HOHENWALD
State	:	TN
Zip	:	38462-2605
Country	:	US
Telephone Number	:	931-796-2565
Fax Number	:	931-796-2566

Provider Business Practice Location Address
First Line	:	442 E MAIN ST
Second Line	:
City	:	HOHENWALD
State	:	TN
Zip	:	38462-2605
Country	:	US
Telephone Number	:	931-796-2565
Fax Number	:	931-796-2566

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2006
Last Update Date	:	09/23/2024

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