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1295040186
CORRIE LYNN GRAVES TICE
KANSAS CITY, MO
NPI
1295040186
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Former Name
CORRIE LYNN GRAVES
Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: MO 20000152219)
Enumeration Date
2010-08-16
Last Update Date
2010-08-16
Business Address
Ms. CORRIE LYNN GRAVES TICE PT
2727 TRACY AVE
KANSAS CITY, MO 64109-1243
Phone number: 816-889-3502
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Mailing Address
Ms. CORRIE LYNN GRAVES TICE PT
201 NE 83RD TER
KANSAS CITY, MO 64118-1253
Phone number: 816-420-9901
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