Organization
DEBARY CHIROPRACTIC CENTER CORP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMIE GRAINGER DC (OWNER)
(386) 668-6321
Entity
Organization
Contact information
Practice address
70 FOX RIDGE CT STE A, DEBARY, FL 32713-2752
(386) 668-6321
Mailing address
70 FOX RIDGE CT STE A, DEBARY, FL 32713-2752
(386) 668-6321
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH12148
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058586
UHC OPTUM
FL
Enumeration date
07/10/2017
Last updated
01/20/2021
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