Provider Demographics
NPI:1033974134
Name:GRACE THERAPY AND WELLNESS
Entity Type:Organization
Organization Name:GRACE THERAPY AND WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OCCUPATIONAL THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BETHANY
Authorized Official - Middle Name:
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:OTR/L
Authorized Official - Phone:423-887-4500
Mailing Address - Street 1:209 COUNTY ROAD 260
Mailing Address - Street 2:
Mailing Address - City:NIOTA
Mailing Address - State:TN
Mailing Address - Zip Code:37826-2917
Mailing Address - Country:US
Mailing Address - Phone:423-887-4500
Mailing Address - Fax:
Practice Address - Street 1:209 COUNTY ROAD 260
Practice Address - Street 2:
Practice Address - City:NIOTA
Practice Address - State:TN
Practice Address - Zip Code:37826-2917
Practice Address - Country:US
Practice Address - Phone:423-887-4500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-16
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy