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Organization

GRANT STREET CHIROPRACTIC PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DOUGLAS GEORGE FREY DC (PRESIDENT)
(563) 852-3396
Entity
Organization

Contact information

Practice address
206 GRANT STREET SW, CASCADE, IA 52033-0456
(563) 852-3396
Mailing address
206 GRANT STREET SW, CASCADE, IA 52033-0456
(563) 852-3396

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
6468
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0256768
IA
Enumeration date
12/28/2006
Last updated
01/07/2008
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