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NPI Code Detail

MEDICARE: LAWRENCE A GRALEWSKI

MEDICARE: LAWRENCE A GRALEWSKI
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
1111N00000XChiropractorLG005027MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
17393005OTHERMIAETNA

General Provider Information

NPI Number : 1669499356
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAWRENCE A GRALEWSKI
Provider Business Mailing Address
First Line : 48635 CRESCENT DR
Second Line :
City : MACOMB
State : MI
Zip : 48044-2117
Country : US
Telephone Number : 586-949-3799
Fax Number : 313-383-7295
Provider Business Practice Location Address
First Line : 2178 FORT ST
Second Line :
City : LINCOLN PARK
State : MI
Zip : 48146-2405
Country : US
Telephone Number : 313-383-7227
Fax Number : 313-383-7295
Authorized Official
Title or Position : PROVIDER
Name : LAWRENCE A GRALEWSKI
Credential : DC
Telephone Number : 313-383-7227
Provider Enumeration Date : 07/17/2006
Last Update Date : 08/22/2020

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Directions to “LAWRENCE A GRALEWSKI ” Practice Location

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