Individual
JACQUELINE GAIL GRAGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
992 TAMIAMI TRL, PORT CHARLOTTE, FL 33953-3868
(941) 888-4710
Mailing address
15422 ANCEL CIR, PORT CHARLOTTE, FL 33981-4213
(816) 820-8033
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
23333
FL
Other
Enumeration date
03/27/2023
Last updated
03/27/2023
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