Provider Demographics
NPI:1205004736
Name:AMERICAN HEALTH CENTERS OF GRAYSON, INC
Entity Type:Organization
Organization Name:AMERICAN HEALTH CENTERS OF GRAYSON, INC
Other - Org Name:AMERICAN HEALTH CENTERS OF GRAYSON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:HOLLY
Authorized Official - Middle Name:DAWN
Authorized Official - Last Name:LAWSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:740-646-7321
Mailing Address - Street 1:103 THELMA AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH POINT
Mailing Address - State:OH
Mailing Address - Zip Code:45680-9203
Mailing Address - Country:US
Mailing Address - Phone:740-646-7321
Mailing Address - Fax:
Practice Address - Street 1:186 INTERSTATE DR
Practice Address - Street 2:
Practice Address - City:GRAYSON
Practice Address - State:KY
Practice Address - Zip Code:41143-1787
Practice Address - Country:US
Practice Address - Phone:740-646-7321
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-19
Last Update Date:2008-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4440111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty