Provider Demographics
NPI:1427392570
Name:NOBLES, GRANT MICHAEL (DC)
Entity Type:Individual
Prefix:DR
First Name:GRANT
Middle Name:MICHAEL
Last Name:NOBLES
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 1:406 4TH ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:SERGEANT BLUFF
Mailing Address - State:IA
Mailing Address - Zip Code:51054-8579
Mailing Address - Country:US
Mailing Address - Phone:712-943-2068
Mailing Address - Fax:712-943-8082
Practice Address - Street 1:406 4TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:SERGEANT BLUFF
Practice Address - State:IA
Practice Address - Zip Code:51054-8579
Practice Address - Country:US
Practice Address - Phone:712-943-2068
Practice Address - Fax:712-943-8082
Is Sole Proprietor?:No
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007601111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor