Provider Demographics
NPI:1447064290
Name:HERNANDEZ, GRACE P (DPT)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:P
Last Name:HERNANDEZ
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7626 SPANISH FORT BLVD
Mailing Address - Street 2:
Mailing Address - City:SPANISH FORT
Mailing Address - State:AL
Mailing Address - Zip Code:36527-5376
Mailing Address - Country:US
Mailing Address - Phone:251-929-4848
Mailing Address - Fax:251-850-5080
Practice Address - Street 1:7626 SPANISH FORT BLVD
Practice Address - Street 2:
Practice Address - City:SPANISH FORT
Practice Address - State:AL
Practice Address - Zip Code:36527-5376
Practice Address - Country:US
Practice Address - Phone:251-929-4848
Practice Address - Fax:251-850-5080
Is Sole Proprietor?:No
Enumeration Date:2025-02-03
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist