Provider Demographics
NPI:1639294416
Name:GRAYSON CHIROPRACTIC ASSOC
Entity Type:Organization
Organization Name:GRAYSON CHIROPRACTIC ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:FRANK
Authorized Official - Middle Name:L
Authorized Official - Last Name:GRAYSON
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:585-271-6080
Mailing Address - Street 1:121 RUE DE VILLE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14618-5619
Mailing Address - Country:US
Mailing Address - Phone:585-271-6080
Mailing Address - Fax:585-271-6816
Practice Address - Street 1:121 RUE DE VILLE
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14618-5619
Practice Address - Country:US
Practice Address - Phone:585-271-6080
Practice Address - Fax:585-271-6816
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY38801111N00000X
NY35551111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty