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1104016682
LACEY ANN GRACE
LEBANON, NH
NPI
1104016682
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: NH 0845)
Enumeration Date
2007-07-31
Last Update Date
2007-07-31
Business Address
Mrs. LACEY ANN GRACE PTA
24 OLD ETNA RD
LEBANON, NH 03766-1937
Phone number: 603-442-4207
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Mailing Address
Mrs. LACEY ANN GRACE PTA
130 JAMES ST
CHARLESTOWN, NH 03603-4716
Phone number: 603-826-5702
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