Provider Demographics
NPI:1356984116
Name:GRAZIANO CHIROPRACTIC
Entity type:Organization
Organization Name:GRAZIANO CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AURIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAZIANO
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:570-903-0472
Mailing Address - Street 1:228 NEWTON RD
Mailing Address - Street 2:
Mailing Address - City:SCRANTON
Mailing Address - State:PA
Mailing Address - Zip Code:18504-1008
Mailing Address - Country:US
Mailing Address - Phone:570-903-0472
Mailing Address - Fax:
Practice Address - Street 1:1 MAXSON DR
Practice Address - Street 2:
Practice Address - City:OLD FORGE
Practice Address - State:PA
Practice Address - Zip Code:18518-2081
Practice Address - Country:US
Practice Address - Phone:570-903-0472
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-24
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty