Provider Demographics
NPI:1265704258
Name:GUY R GRINSELL, D.C., LLC
Entity type:Organization
Organization Name:GUY R GRINSELL, D.C., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:GUY
Authorized Official - Middle Name:ROBERT
Authorized Official - Last Name:GRINSELL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:401-722-3380
Mailing Address - Street 1:600 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:PAWTUCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02861-1957
Mailing Address - Country:US
Mailing Address - Phone:401-722-3380
Mailing Address - Fax:401-722-3380
Practice Address - Street 1:600 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PAWTUCKET
Practice Address - State:RI
Practice Address - Zip Code:02861-1957
Practice Address - Country:US
Practice Address - Phone:401-722-3380
Practice Address - Fax:401-722-3380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDCP00211111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty