Organization Name: | GORDON H GRANNIS, D.C., A CHIROPRACTIC PROFESSIONAL CORPORATION |
NPI Number: | 1235241944 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | GORDON HARRIMAN GRANNIS (PRESIDENT) |
Mailing Address: | 24541 Pacific Park Dr Ste 290 Aliso Viejo |
State: | CA US |
Postal Code: | 926563058 |
Phone Number: | 9494488599 |
Fax Number: | 9494488595 |
NPI Enumeration Date: | 08/31/2006 |
NPI Last Update Date: | 04/20/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | DC12688 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |