Organization
COOL CREEK CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRANT ROMINE D.C. (MEMBER)
(317) 818-1414
Entity
Organization
Contact information
Practice address
14747 OAK ROAD BLD 3, SUITE 300, CARMEL, IN 46033
(317) 818-1414
Mailing address
14747 OAK RD, SUITE 300, CARMEL, IN 46033-8183
(317) 818-1414
(317) 818-1014
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08002343A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M100064022
MEDICARE PTAN
IN
Enumeration date
10/16/2007
Last updated
05/14/2014
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