Individual
MRS. GRACE RADNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
97 CORNELL DR, SMITHTOWN, NY 11787-3022
(631) 543-1414
Mailing address
97 CORNELL DR, SMITHTOWN, NY 11787-3022
(631) 543-1414
(631) 543-1414
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
018488-1
NY
Other
Enumeration date
01/06/2011
Last updated
01/06/2011
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