Provider Demographics
NPI:1285672170
Name:GBC GROTTS INC.
Entity Type:Organization
Organization Name:GBC GROTTS INC.
Other - Org Name:NATURAL HEALTH CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:GROTTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:370-245-6513
Mailing Address - Street 1:1150 N 25TH ST
Mailing Address - Street 2:STE D
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-6594
Mailing Address - Country:US
Mailing Address - Phone:970-245-6513
Mailing Address - Fax:970-245-6599
Practice Address - Street 1:1150 N 25TH ST
Practice Address - Street 2:STE D
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501-6594
Practice Address - Country:US
Practice Address - Phone:970-245-6513
Practice Address - Fax:970-245-6599
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5020111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COC802021Medicare PIN