Organization
GRACE MEDICAL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SANDI MATTOX (OWNER)
(651) 430-8184
Entity
Organization
Contact information
Practice address
355 S TELLER ST, SUITE 200, LAKEWOOD, CO 80226-7390
(866) 514-7223
(866) 823-2252
Mailing address
1106 2ND ST N, STILLWATER, MN 55082-4059
(651) 430-8184
(866) 823-2252
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12229873
—
CO
Enumeration date
08/07/2014
Last updated
08/31/2016
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