Individual
MRS. DONNA BROWDER GRACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
40 MILLIKEN LN, ST AUGUSTINE, FL 32080-8425
(404) 630-3595
(404) 630-3595
Mailing address
40 MILLIKEN LN, ST AUGUSTINE, FL 32080-8425
(404) 630-3595
(404) 630-3595
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT005235
GA
225100000X
Physical Therapist
Primary
PT28203
FL
2251N0400X
Neurology Physical Therapist
PT005235
GA
2251P0200X
Pediatric Physical Therapist
PT005235
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000902767A
—
GA
Enumeration date
05/15/2006
Last updated
07/30/2014
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