Individual
DR. GRACE ELAINE JORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
240 W BURNSIDE AVE, CHUBBUCK, ID 83202-4702
(303) 957-6131
Mailing address
5533 NEZ PERCE DR, POCATELLO, ID 83204-4613
(303) 957-6131
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-6999
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
87852071
—
CO
Enumeration date
07/23/2009
Last updated
10/25/2024
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