MEDICARE: DR. CODY CHRISTOPHER GRIGSBY DC

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	CH13233	FL

General Provider Information

NPI Number	:	1629684022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CODY CHRISTOPHER GRIGSBY DC

Provider Business Mailing Address
First Line	:	637 MOONDANCER CT
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33410-1542
Country	:	US
Telephone Number	:	419-303-4172
Fax Number	:

Provider Business Practice Location Address
First Line	:	421 NORTHLAKE BLVD
Second Line	:
City	:	PALM BEACH GARDENS
State	:	FL
Zip	:	33408-5413
Country	:	US
Telephone Number	:	561-842-2273
Fax Number	:

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

Provider Enumeration Date	:	09/21/2020
Last Update Date	:	09/24/2021

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