Organization
GRACE CIRCLE, LLC
Active
Other names
The Grace Circle
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA R GIBSON M.S. OTR/L (OCCUPATIONAL THERAPIST)
(334) 590-0164
Entity
Organization
Contact information
Practice address
4209 CARMICHAEL RD, MONTGOMERY, AL 36106-3601
(334) 356-1020
(334) 356-2177
Mailing address
4209 CARMICHAEL RD, MONTGOMERY, AL 36106-3601
(334) 356-1020
(334) 356-2177
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
224Z00000X
Occupational Therapy Assistant
—
—
2251P0200X
Pediatric Physical Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
329777
—
AL
Enumeration date
10/23/2023
Last updated
08/26/2025
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