Provider Demographics
NPI:1467631283
Name:GRUBBS FAMILY CHIROPRACTIC INC.
Entity Type:Organization
Organization Name:GRUBBS FAMILY CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:F
Authorized Official - Last Name:GRUBBS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:330-627-4745
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2013-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2687111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2091829Medicaid
OHGR9341371Medicare PIN
OHU74250Medicare UPIN