Provider Demographics
NPI:1720127277
Name:TANG, GRACE (DPT)
Entity Type:Individual
Prefix:MRS
First Name:GRACE
Middle Name:
Last Name:TANG
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:EUN
Other - Middle Name:HAH
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:5103 GRACE PARK DR
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-6002
Mailing Address - Country:US
Mailing Address - Phone:919-535-8907
Mailing Address - Fax:
Practice Address - Street 1:6406 MCCRIMMON PKWY
Practice Address - Street 2:SUITE 250
Practice Address - City:MORRISVILLE
Practice Address - State:NC
Practice Address - Zip Code:27560-8144
Practice Address - Country:US
Practice Address - Phone:919-467-4558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0248122251X0800X
NC120892251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic