Provider Demographics
NPI:1295274280
Name:IGNATZ, GRACE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:GRACE
Middle Name:
Last Name:IGNATZ
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 PARKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15017-1267
Mailing Address - Country:US
Mailing Address - Phone:412-789-5759
Mailing Address - Fax:
Practice Address - Street 1:1216 PARKSIDE DR
Practice Address - Street 2:
Practice Address - City:BRIDGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15017-1267
Practice Address - Country:US
Practice Address - Phone:412-789-5759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-23
Last Update Date:2024-10-08
Deactivation Date:2020-06-24
Deactivation Code:
Reactivation Date:2020-07-22
Provider Licenses
StateLicense IDTaxonomies
PAPT025789225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist