Provider Demographics
NPI:1013249911
Name:GRANITE, ADRIAN A (DC)
Entity Type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:A
Last Name:GRANITE
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 1:333 ELM ST
Mailing Address - Street 2:SUITE 120
Mailing Address - City:DEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02026-4530
Mailing Address - Country:US
Mailing Address - Phone:781-467-0088
Mailing Address - Fax:
Practice Address - Street 1:333 ELM ST
Practice Address - Street 2:SUITE 120
Practice Address - City:DEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02026-4530
Practice Address - Country:US
Practice Address - Phone:781-467-0088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-03
Last Update Date:2014-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3317111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor