MEDICARE: DENA DELVARON GRANGER 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	2675	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

General Provider Information

NPI Number	:	1750653572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENA DELVARON GRANGER D.C.

Provider Business Mailing Address
First Line	:	76 TABB DRIVE
Second Line	:	SUITE C
City	:	MUNFORD
State	:	TN
Zip	:	38058
Country	:	US
Telephone Number	:	901-840-2234
Fax Number	:	901-840-2237

Provider Business Practice Location Address
First Line	:	3615 S HOUSTON LEVEE RD
Second Line	:
City	:	COLLIERVILLE
State	:	TN
Zip	:	38017-9192
Country	:	US
Telephone Number	:	901-221-7173
Fax Number	:	901-221-7934

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

Provider Enumeration Date	:	02/09/2012
Last Update Date	:	11/15/2018

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Directions to “ DENA DELVARON GRANGER D.C.” Practice Location

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