Provider Demographics
NPI:1215003785
Name:GRANT, KERRI LYNN (DC)
Entity Type:Individual
Prefix:DR
First Name:KERRI
Middle Name:LYNN
Last Name:GRANT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 FILLMORE RD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5812
Mailing Address - Country:US
Mailing Address - Phone:603-380-2026
Mailing Address - Fax:603-319-4604
Practice Address - Street 1:1950 LAFAYETTE ROAD
Practice Address - Street 2:SUITE301
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801
Practice Address - Country:US
Practice Address - Phone:603-380-2026
Practice Address - Fax:603-319-4604
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH769-0806111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor