Organization
GRACE CHIROPRACTIC CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY CLAY GROSS D.C. (OWNER)
(501) 941-3008
Entity
Organization
Contact information
Practice address
309 W MAIN ST, CABOT, AR 72023-2911
(501) 941-3008
(501) 941-3007
Mailing address
PO BOX 688, CABOT, AR 72023-0688
(501) 941-3008
(501) 941-3007
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1674
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
06060023300
QUAL CHOICE
AR
01
—
5032683
CIGNA
AR
01
—
5Y850
BLUE CROSS BLUE SHEILD
AR
01
—
7172792
AETNA
AR
Enumeration date
12/04/2006
Last updated
08/22/2020
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