Provider Demographics
NPI:1346904737
Name:GRAGG, CHRISTIAN LEIGH
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:LEIGH
Last Name:GRAGG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 COURT DR
Mailing Address - Street 2:
Mailing Address - City:GASTONIA
Mailing Address - State:NC
Mailing Address - Zip Code:28054-1478
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8440 PIT STOP CT NW STE 140
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-8246
Practice Address - Country:US
Practice Address - Phone:704-960-1729
Practice Address - Fax:980-225-7274
Is Sole Proprietor?:No
Enumeration Date:2021-10-22
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist