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Organization

CHIROPRACTIC HEALTH CLINIC OF BREVARD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAUL VINCENT GRIMM D.C. (PRESIDENT)
(321) 459-9400
Entity
Organization

Contact information

Practice address
110 N TROPICAL TRL, MERRITT ISLAND, FL 32953-4737
(321) 459-9400
Mailing address
110 N TROPICAL TRL, MERRITT ISLAND, FL 32953-4737

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH 8328 FL
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
K5848
MEDICARE GROUP NUMBER
FL
Enumeration date
07/27/2007
Last updated
07/27/2007
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