Provider Demographics
NPI:1811568645
Name:ASHLEY RIVER CHIROPRACTIC
Entity Type:Organization
Organization Name:ASHLEY RIVER CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CHIROPRACTOR
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:J
Authorized Official - Last Name:GROCHOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:909-953-1861
Mailing Address - Street 1:2408 ASHLEY RIVER RD UNIT Z
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29414-4619
Mailing Address - Country:US
Mailing Address - Phone:909-953-1861
Mailing Address - Fax:
Practice Address - Street 1:2408 ASHLEY RIVER RD UNIT Z
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-4619
Practice Address - Country:US
Practice Address - Phone:909-953-1861
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-02
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty