Individual
MS. GREW GRACE LOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
12839 W PORTAGE RIVER SOUTH RD, OAK HARBOR, OH 43449-9687
(419) 707-4481
Mailing address
3318 20TH AVE S, SEATTLE, WA 98144
(419) 707-4481
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/17/2019
Last updated
08/12/2022
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