Provider Demographics
NPI:1265448047
Name:GRUBBS, WILLIAM FRANK (DC)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:FRANK
Last Name:GRUBBS
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:PO BOX 56
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:44615-0056
Mailing Address - Country:US
Mailing Address - Phone:330-627-4745
Mailing Address - Fax:330-627-9767
Practice Address - Street 1:713 CANTON RD NW
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:44615-9447
Practice Address - Country:US
Practice Address - Phone:330-627-4745
Practice Address - Fax:330-627-9767
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2013-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2687111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2091829Medicaid
OH2091829Medicaid
OHGR9341371Medicare ID - Type UnspecifiedMEDICARE
OH2091829Medicaid