Most Relevant Information
Provider Data
| NPI Number: | 1003045832 |
| Provider Name: | NICOLE MARIE GRANGER LMT, LMP |
| Entity Type: | Individual |
| Taxonomy Code: | 111N00000X |
| Specialty: | Chiropractor |
| License Number: | 15945 |
Most Important Dates
| Enumeration Date: | 07/14/2009 |
| Last Updated: | 03/12/2013 |
Provider Practice Location
13712 NE 20TH AVE
VANCOUVER
WA
986862698
Practice Location Phone/Fax
| Phone: | 3605745944 |
| Fax: |
Provider Mailing Location
9638 SW LARSON RD
GASTON
OR
971197721
Provider Mailing Phone/Fax
| Phone: | 5039980418 |
| Fax: |