Individual
PETER MATTHEW GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
160 VERSAILLES RD, FRANKFORT, KY 40601-3207
(502) 695-4455
(502) 695-0727
Mailing address
160 VERSAILLES RD, FRANKFORT, KY 40601-3207
(502) 695-4455
(502) 695-0727
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
4715
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000292695
ANTHEM
KY
05
—
50004093
—
KY
Enumeration date
12/18/2006
Last updated
07/08/2007
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