Individual
GRACE NICOLE PARKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1377 11TH ST NW, CLINTON, IA 52732-5068
(877) 563-6356
Mailing address
4015 LILLIE AVE APT 108, DAVENPORT, IA 52806-4437
(563) 549-2618
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
110476
IA
Other
Enumeration date
10/25/2021
Last updated
10/25/2021
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