Individual
MS. TRACY GRIMES SHUMATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
204 S MAPLE ST, VINTON, VA 24179-2522
(540) 266-6950
(540) 343-3982
Mailing address
204 S MAPLE ST, VINTON, VA 24179-2522
(540) 266-6950
(540) 343-3982
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
0119002297
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0119002297
LICENSE
VA
Enumeration date
08/20/2007
Last updated
08/20/2007
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