Individual
GRACE POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3851 COMMERCIAL CENTER DR, LADSON, SC 29456-4146
(843) 314-5434
(888) 510-9156
Mailing address
3851 COMMERCIAL CENTER DR, LADSON, SC 29456-4146
(843) 314-5434
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9708
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9708
STATE LICENSE
SC
Enumeration date
06/04/2019
Last updated
06/04/2019
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