Organization
GREAT BASIN SPINE AND SPORTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL GREGORY GRAVES D.C. (SINGLE MEMBER)
(801) 627-2023
Entity
Organization
Contact information
Practice address
134 E 4600 S, WASHINGTON TERRACE, UT 84405-5946
(801) 627-2023
Mailing address
134 E 4600 S, WASHINGTON TERRACE, UT 84405-5946
(801) 627-2023
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7617785-1202
UT
Other
Enumeration date
08/24/2010
Last updated
12/28/2010
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