Individual
EMILY GRACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MAT, ATC
Contact information
Practice address
10407 CLAYTON RD, SAINT LOUIS, MO 63131-2909
(314) 692-0445
Mailing address
665 S SKINKER BLVD APT 9E, SAINT LOUIS, MO 63105-2347
(920) 655-8688
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2014022604
MO
Other
Enumeration date
08/14/2014
Last updated
08/14/2014
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