Provider Demographics
NPI:1568164804
Name:BISCHOFF, GRACE MARIE (DPT)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:MARIE
Last Name:BISCHOFF
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:MARIE
Other - Last Name:COMERFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:148 E ARAPAHOE ST
Mailing Address - Street 2:
Mailing Address - City:THERMOPOLIS
Mailing Address - State:WY
Mailing Address - Zip Code:82443-2402
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:148 E ARAPAHOE ST
Practice Address - Street 2:
Practice Address - City:THERMOPOLIS
Practice Address - State:WY
Practice Address - Zip Code:82443-2402
Practice Address - Country:US
Practice Address - Phone:307-864-2146
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2023-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYPT-2258225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist