# GRACE UROLOGICAL INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699819227
- **Authorized official:** JOHN S.F. DALY M.D. (PRESIDENT)
- **Authorized official phone:** (802) 257-4265

## Contact information

- **Practice address:** 191 CLARK AVE, SUITE 1, BRATTLEBORO, VT 05301-3400
- **Practice address phone:** (802) 257-4265
- **Practice address fax:** (802) 258-3809
- **Mailing address:** 191 CLARK AVE, SUITE 1, BRATTLEBORO, VT 05301-3400
- **Mailing address phone:** (802) 257-4265
- **Mailing address fax:** (802) 258-3809

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208800000X | Urology Physician | 420008109 | VT | Yes |

## Other

- **Enumeration date:** 02/16/2007
- **Last updated:** 04/04/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0VN0579 | — | VT |