GRACE LA PORTE

MYSTIC, CT
NPI1154155653
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: CT  14591)
Additional Taxonomies225100000X Physical Therapist
(Licence: NY  052932)
Enumeration Date2024-08-27
Last Update Date2024-08-27
Business Address
GRACE LA PORTE DPT
2440 GOLD STAR HWY UNIT 201
MYSTIC, CT 06355-1180
Phone number: 860-536-1001
Mailing Address
GRACE LA PORTE DPT
274 MASON RD
MOHAWK, NY 13407-3902
Phone number: 315-717-8264