Provider Demographics
NPI:1679029151
Name:GRADY, NICK (DC)
Entity Type:Individual
Prefix:DR
First Name:NICK
Middle Name:
Last Name:GRADY
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 1:26 W DRY CREEK CIR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-8063
Mailing Address - Country:US
Mailing Address - Phone:720-523-1293
Mailing Address - Fax:720-523-1296
Practice Address - Street 1:26 W DRY CREEK CIR
Practice Address - Street 2:SUITE 600
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-8063
Practice Address - Country:US
Practice Address - Phone:720-523-1293
Practice Address - Fax:720-523-1296
Is Sole Proprietor?:No
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCHR.0007491111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor