Individual
GRACE MADISON PURVIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
4209 CARMICHAEL RD, MONTGOMERY, AL 36106-3601
(334) 356-1020
(334) 356-2177
Mailing address
2021 HOME PARK TRL APT 312, PRATTVILLE, AL 36066-7808
(334) 300-8556
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5919
AL
Other
Enumeration date
09/19/2023
Last updated
04/10/2024
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