Provider Demographics
NPI:1235622861
Name:MONCATAR, GRACE (DPT)
Entity Type:Individual
Prefix:MS
First Name:GRACE
Middle Name:
Last Name:MONCATAR
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:MS
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:DELMUNDO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:1401 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:ROCKFORD
Mailing Address - State:IL
Mailing Address - Zip Code:61104-2315
Mailing Address - Country:US
Mailing Address - Phone:815-489-4590
Mailing Address - Fax:
Practice Address - Street 1:209 9TH ST STE 101
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61104-2235
Practice Address - Country:US
Practice Address - Phone:815-489-4590
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-08
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist