Provider Demographics
NPI:1154605970
Name:MILLER, GRACE E (PT, DPT)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:E
Last Name:MILLER
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 1:606 LANE ALLEN RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-3507
Mailing Address - Country:US
Mailing Address - Phone:740-398-3254
Mailing Address - Fax:859-369-8113
Practice Address - Street 1:606 LANE ALLEN RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40504-3507
Practice Address - Country:US
Practice Address - Phone:740-398-3254
Practice Address - Fax:859-369-8113
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2022-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY005900225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist