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Individual
DR. THOMAS GRACE
Active
Individual
DR. THOMAS GRACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
5740
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5740
OBCE
OR
Enumeration date
08/31/2016
Last updated
08/31/2016
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