Individual
MRS. VICKIE L GRAGG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
401 E MAIN ST, JOHNSON CITY, TN 37601-4877
(423) 722-2062
Mailing address
104 HARMONY HEIGHTS RD, JONESBOROUGH, TN 37659-3218
(423) 262-7861
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
4161
TN
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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