Individual
MRS. HEATHER DAWN GRAGG
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MPT
Contact information
Practice address
207 MERCHANTS WALK, SUMMERSVILLE, WV 26651
(304) 872-7498
(304) 872-8144
Mailing address
PO BOX 987, SUMMERSVILLE, WV 26651-0987
(304) 872-7498
(304) 872-8144
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810003510
—
WV
Enumeration date
01/10/2006
Last updated
07/08/2007
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