Individual
MRS. GRAY PACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1190 N STATE ST, JACKSON, MS 39202-2413
(601) 968-1148
(601) 968-1337
Mailing address
PO BOX 23090, JACKSON, MS 39225-3090
(601) 968-1148
(601) 968-1337
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2358
MS
Other
Enumeration date
01/14/2011
Last updated
01/14/2011
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