Organization
GREATER LIFE CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GRANT LISETOR DC (CHIROPRACTOR)
(704) 770-8436
Entity
Organization
Contact information
Practice address
624 TYVOLA RD, SUITE 100, CHARLOTTE, NC 28217-3578
(704) 770-8436
Mailing address
624 TYVOLA RD, SUITE 100, CHARLOTTE, NC 28217-3578
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4490
NC
Other
Enumeration date
11/10/2014
Last updated
11/10/2014
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