Provider Demographics
NPI:1912925553
Name:GRANTZ, LUKE AARON (DC)
Entity Type:Individual
Prefix:DR
First Name:LUKE
Middle Name:AARON
Last Name:GRANTZ
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 1:7908 CINCINNATI DAYTON RD
Mailing Address - Street 2:SUITE X
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-6602
Mailing Address - Country:US
Mailing Address - Phone:513-895-9355
Mailing Address - Fax:513-893-9355
Practice Address - Street 1:7908 CINCINNATI DAYTON RD
Practice Address - Street 2:SUITE X
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-6602
Practice Address - Country:US
Practice Address - Phone:513-895-9355
Practice Address - Fax:513-893-9355
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2009-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2631111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2050935Medicaid
OHU76849Medicare UPIN
OH2050935Medicaid