Individual
SHANNON GRAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
156 WEST AVE, BROCKPORT, NY 14420-1229
(585) 275-5321
Mailing address
156 WEST AVE, BROCKPORT, NY 14420-1229
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
049751-01
NY
Other
Enumeration date
12/06/2022
Last updated
12/06/2022
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