Provider Demographics
NPI:1164726717
Name:GRINDER, NATHAN EDWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:EDWARD
Last Name:GRINDER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4337 E AMBER LN
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85296-1585
Mailing Address - Country:US
Mailing Address - Phone:602-430-4486
Mailing Address - Fax:480-809-4988
Practice Address - Street 1:2815 E OCOTILLO RD STE 4
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-6040
Practice Address - Country:US
Practice Address - Phone:480-781-2964
Practice Address - Fax:480-809-4988
Is Sole Proprietor?:No
Enumeration Date:2010-12-22
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8174111NR0400X, 111NS0005X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation
No111NS0005XChiropractic ProvidersChiropractorSports Physician