Lacey Ann Grace PTA

NPI 1104016682 - Physical Therapy Assistant - 225200000X

NPI Details
NPI 1104016682
Gender Female
Enumeration Date 07/31/2007
Last Updated 07/31/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
24 OLD ETNA RD
LEBANON NH, 03766-1937, US
Phone (603) 442-4207
Fax (603) 442-4250
Business Location
130 JAMES ST
CHARLESTOWN NH, 03603-4716, US
Phone (603) 826-5702
Fax
Toxanomy
Taxonomy Code 225200000X
License State New Hampshire
License Number 0845
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According to our database, Mrs. Lacey Ann Grace PTA NPI is 1104016682, taxonomy code is 225200000X and license number is 0845, license state is located at New Hampshire. Lacey Ann Grace PTA physically located at 24 Old Etna Rd, Lebanon NH, 03766-1937. NPI Number Lacey Ann Grace PTA has the Individual type.

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1104016682 NPI number is provided on an as is basis without warranty of any kind. 1104016682 is maintained by the National Plan & Provider Enumeration System. The contents of Lacey Ann Grace PTA are for informational purposes only.