Provider Demographics
NPI:1235919366
Name:GRACEYFEET LLC
Entity Type:Organization
Organization Name:GRACEYFEET LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:CHRISTOPHER
Authorized Official - Last Name:GRACEY
Authorized Official - Suffix:
Authorized Official - Credentials:MPT, CPED
Authorized Official - Phone:202-210-7074
Mailing Address - Street 1:5709 CHEVY CHASE PKWY NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2521
Mailing Address - Country:US
Mailing Address - Phone:202-210-7074
Mailing Address - Fax:
Practice Address - Street 1:8300 BURDETTE RD
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-2801
Practice Address - Country:US
Practice Address - Phone:202-210-7074
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-05
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No171000000XOther Service ProvidersMilitary Health Care ProviderGroup - Multi-Specialty
No225000000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotic FitterGroup - Multi-Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
No225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No335E00000XSuppliersProsthetic/Orthotic Supplier