Provider Demographics
NPI:1992151625
Name:GRACE CHIROPRACTIC, PLLC
Entity type:Organization
Organization Name:GRACE CHIROPRACTIC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:RATHBONE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:828-708-8808
Mailing Address - Street 1:315 S CHURCH ST
Mailing Address - Street 2:C
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28792-6237
Mailing Address - Country:US
Mailing Address - Phone:828-435-2377
Mailing Address - Fax:828-412-4382
Practice Address - Street 1:315 S CHURCH ST
Practice Address - Street 2:C
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-6237
Practice Address - Country:US
Practice Address - Phone:828-435-2377
Practice Address - Fax:828-412-4382
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-12
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4476111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty