Provider Demographics
NPI:1619159092
Name:GRAF, JUSTIN C (DC)
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:C
Last Name:GRAF
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 1:151 N CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:BATH
Mailing Address - State:PA
Mailing Address - Zip Code:18014-1138
Mailing Address - Country:US
Mailing Address - Phone:610-837-8854
Mailing Address - Fax:
Practice Address - Street 1:151 N CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:BATH
Practice Address - State:PA
Practice Address - Zip Code:18014-1138
Practice Address - Country:US
Practice Address - Phone:610-837-8854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC009856111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor