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Individual
MS. SUZANNE GRACE
Active
Individual
MS. SUZANNE GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
10851
NC
225100000X
Physical Therapist
5233
SC
225100000X
Physical Therapist
Primary
5564
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1512782
—
TN
01
—
4223417
BLUECROSS BLUESHIELD
TN
01
—
P00747042
RAILROAD MEDICARE
—
Enumeration date
12/05/2007
Last updated
10/20/2009
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