Provider Demographics
NPI:1639668619
Name:BETZ, GRACE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:GRACE
Middle Name:
Last Name:BETZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:
Other - Last Name:LANCASTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:1380 FAIRCREST LN
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-0596
Mailing Address - Country:US
Mailing Address - Phone:864-921-7238
Mailing Address - Fax:
Practice Address - Street 1:1295 HEMBREE RD STE A201
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4953
Practice Address - Country:US
Practice Address - Phone:678-731-7772
Practice Address - Fax:678-731-7773
Is Sole Proprietor?:No
Enumeration Date:2018-05-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist