Provider Demographics
NPI:1588849467
Name:GRAYBAR-CLINTON, INC
Entity Type:Organization
Organization Name:GRAYBAR-CLINTON, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAYBAR
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:910-285-7222
Mailing Address - Street 1:PO BOX 15231
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28408-5231
Mailing Address - Country:US
Mailing Address - Phone:910-790-3407
Mailing Address - Fax:910-313-0695
Practice Address - Street 1:600 BEAMAN ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NC
Practice Address - Zip Code:28328-9998
Practice Address - Country:US
Practice Address - Phone:910-596-2222
Practice Address - Fax:910-596-0222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2141111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty