Provider Demographics
NPI:1760723084
Name:COX, GRANT L (DC)
Entity Type:Individual
Prefix:DR
First Name:GRANT
Middle Name:L
Last Name:COX
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 1:110 C ST SW
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:WA
Mailing Address - Zip Code:98848-1207
Mailing Address - Country:US
Mailing Address - Phone:509-787-1918
Mailing Address - Fax:
Practice Address - Street 1:110 C ST SW
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:WA
Practice Address - Zip Code:98848-1207
Practice Address - Country:US
Practice Address - Phone:509-787-1918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-12
Last Update Date:2013-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60335149111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor