Provider Demographics
NPI:1558322537
Name:GRACIO, JANIE M (PT)
Entity Type:Individual
Prefix:MS
First Name:JANIE
Middle Name:M
Last Name:GRACIO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:JANIE
Other - Middle Name:M
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1801 GADSDEN HWY
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-3134
Mailing Address - Country:US
Mailing Address - Phone:205-228-7600
Mailing Address - Fax:
Practice Address - Street 1:1801 GADSDEN HWY
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35235-3134
Practice Address - Country:US
Practice Address - Phone:205-228-7600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-30
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALPTH2326225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051003261OtherBCBS OF ALABAMA