Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 2301002891 | MI |
NPI | 1003931999 |
---|---|
Provider Name | Dr. Brian Lavern Grappin |
First Address | Flushing, NY 48433 |
Second Address | Flushing, NY 48433 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0B55060 | BCBS (01) | MI |