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1962762260
MARY GRACE A BAUTISTA
PORTLAND, OR
NPI
1962762260
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: OR PT63986)
Enumeration Date
2012-05-21
Last Update Date
2023-12-29
Business Address
MARY GRACE A BAUTISTA PT
11782 SW BARNES RD STE 300
PORTLAND, OR 97225-5933
Phone number: 503-906-4323
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Mailing Address
MARY GRACE A BAUTISTA PT
1426 S FAIRFIELD AVE
LOMBARD, IL 60148-4669
Phone number:
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