Provider Demographics
NPI:1881219111
Name:GROVE CHIROPRACTIC LLC
Entity Type:Organization
Organization Name:GROVE CHIROPRACTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:E
Authorized Official - Last Name:FRAUDIN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DC
Authorized Official - Phone:412-952-2336
Mailing Address - Street 1:1674 HASTINGS MILL RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-2862
Mailing Address - Country:US
Mailing Address - Phone:412-257-8090
Mailing Address - Fax:412-257-8121
Practice Address - Street 1:1236 GROVE RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15234-2311
Practice Address - Country:US
Practice Address - Phone:412-952-2336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty