Provider Demographics
NPI:1487840054
Name:ROMINE, GRANT THOMAS (DC)
Entity type:Individual
Prefix:DR
First Name:GRANT
Middle Name:THOMAS
Last Name:ROMINE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:14747 OAK RD
Mailing Address - Street 2:BUILDING 3 SUITE 300
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-8101
Mailing Address - Country:US
Mailing Address - Phone:317-818-1414
Mailing Address - Fax:317-818-1014
Practice Address - Street 1:14747 OAK RD
Practice Address - Street 2:BUILDING 3 SUITE 300
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46033-8101
Practice Address - Country:US
Practice Address - Phone:317-818-1414
Practice Address - Fax:317-818-1014
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-18
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN08002343A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor