Individual
NICHOLAS GRAGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4830 HERON POINTE DR APT 822, TAMPA, FL 33616-2934
(315) 720-8392
Mailing address
4830 HERON POINTE DR APT 822, TAMPA, FL 33616-2934
(315) 720-8392
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
11/15/2018
Last updated
11/15/2018
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