Individual
GRACE WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
953 DANBY RD, ITHACA, NY 14850-7002
(607) 274-1456
Mailing address
5134 WORTHINGTON DR, BETHESDA, MD 20816-2730
(240) 515-7988
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
09/16/2024
Last updated
09/16/2024
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