Individual
MR. LEVI DAKOTA GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
615 MCCALLIE AVE, CHATTANOOGA, TN 37403-2504
(423) 425-4111
Mailing address
685 CHAD GRACE RD, RED BOILING SPRINGS, TN 37150-7309
(931) 310-0107
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
06/28/2021
Last updated
06/28/2021
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