Provider Demographics
NPI:1952451676
Name:GRANKA, CHESTER C (DC)
Entity Type:Individual
Prefix:DR
First Name:CHESTER
Middle Name:C
Last Name:GRANKA
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 1:1915 MYERS ST
Mailing Address - Street 2:
Mailing Address - City:OROVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95966
Mailing Address - Country:US
Mailing Address - Phone:530-532-0455
Mailing Address - Fax:530-532-1135
Practice Address - Street 1:1915 MYERS ST
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966
Practice Address - Country:US
Practice Address - Phone:530-532-0455
Practice Address - Fax:530-532-1135
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-12
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CACA14381111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0143810Medicare ID - Type Unspecified