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Individual
MR. STEFAN MATTHEW GRACE
Active
Individual
MR. STEFAN MATTHEW GRACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
091.0125591
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1902343098
NPI
—
Enumeration date
02/26/2015
Last updated
12/06/2022
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