Individual
DR. KEVIN K GRUHOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C., D.A.B.C.O., C.
Contact information
Practice address
2840 19TH AVE S, GRAND FORKS, ND 58201-5957
(701) 772-2670
(701) 772-2706
Mailing address
2840 19TH AVE S, GRAND FORKS, ND 58201-5957
(701) 772-2670
(701) 772-2706
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
516
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010810
BC/BS ND PROVIDER NUMBER
ND
01
—
1003950023
NPI GROUP NUMBER
ND
05
—
16663
—
ND
01
—
1679570758
NPI INDIVIDUAL NUMBER
ND
01
—
675-001
BC/BS CLINIC NUMBER
ND
01
—
N10810
MEDICARE ID-PIN
ND
01
—
N70688
MEDICARE GROUP NUMBER
ND
Enumeration date
07/05/2005
Last updated
09/27/2007
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