Provider Demographics
NPI:1962510487
Name:GRAYKOWSKI, ROBERT (DC)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:GRAYKOWSKI
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 1:5909 STANLEY AVE STE A
Mailing Address - Street 2:
Mailing Address - City:CARMICHAEL
Mailing Address - State:CA
Mailing Address - Zip Code:95608-3803
Mailing Address - Country:US
Mailing Address - Phone:916-973-1611
Mailing Address - Fax:916-973-8273
Practice Address - Street 1:5909 STANLEY AVE STE A
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-3803
Practice Address - Country:US
Practice Address - Phone:916-973-1661
Practice Address - Fax:916-973-8273
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2010-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC0171630111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0171630Medicare UPIN