Provider Demographics
NPI:1063723070
Name:GROHOSKY, FREDERICK M (DC)
Entity type:Individual
Prefix:
First Name:FREDERICK
Middle Name:M
Last Name:GROHOSKY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3036 1ST ST
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19403-1558
Mailing Address - Country:US
Mailing Address - Phone:610-731-1812
Mailing Address - Fax:610-631-2285
Practice Address - Street 1:3036 1ST ST
Practice Address - Street 2:
Practice Address - City:NORRISTOWN
Practice Address - State:PA
Practice Address - Zip Code:19403-1558
Practice Address - Country:US
Practice Address - Phone:610-731-1812
Practice Address - Fax:610-631-2285
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-24
Last Update Date:2014-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC003525L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA189103Medicare PIN
PA000164963Medicare PIN