NPI 1477730141

Mark Charles Grant

Practitioner Chiropractor La Porte, IN

Practice location

Address: 451 Pine Lake Ave, La Porte, IN 46350-2314
Phone: (219) 362-3766

Registered specialties

Chiropractor Primary

Chiropractic Providers Taxonomy 111N00000X Licence 08001545 (IN)

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Registry record

NPI: 1477730141
Entity type: Individual
Sex (as registered): Male
NPI issued: 24 Jan 2008
Record last updated: 24 Jan 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.