Provider Demographics
NPI:1740974484
Name:GRISHKOWSKY, ANDREANNA (DC)
Entity type:Individual
Prefix:
First Name:ANDREANNA
Middle Name:
Last Name:GRISHKOWSKY
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 8TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:ND
Mailing Address - Zip Code:58601-5851
Mailing Address - Country:US
Mailing Address - Phone:907-625-1575
Mailing Address - Fax:907-625-1575
Practice Address - Street 1:2617 SORBUS CIR
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4048
Practice Address - Country:US
Practice Address - Phone:907-625-1575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK205082111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor