Individual
DR. CHRISTIAN PATRICK GRAUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
103 E CONNECTICUT AVE, EDGEWATER, FL 32132-2360
(386) 423-7572
Mailing address
4516 SAXON DR, NEW SMYRNA BEACH, FL 32169-4137
(386) 506-1610
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH10371
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220FM
BC/BS
FL
01
—
FG303Z
MEDICARE PTAN
FL
Enumeration date
07/25/2011
Last updated
03/17/2018
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