Provider Demographics
NPI:1588696231
Name:GRAYSON, JANINE LOUISE (DC)
Entity type:Individual
Prefix:DR
First Name:JANINE
Middle Name:LOUISE
Last Name:GRAYSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 COACH ST
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23664-1726
Mailing Address - Country:US
Mailing Address - Phone:757-851-2377
Mailing Address - Fax:
Practice Address - Street 1:740 DUKE ST
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23510-1515
Practice Address - Country:US
Practice Address - Phone:757-625-4458
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000324111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor