Provider Demographics
NPI:1447963392
Name:TRAINOR, GRACE MARIE (PT, DPT)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:MARIE
Last Name:TRAINOR
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 1:131 STATE ST APT 10
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04101-3748
Mailing Address - Country:US
Mailing Address - Phone:443-791-8593
Mailing Address - Fax:
Practice Address - Street 1:131 STATE ST APT 10
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04101-3748
Practice Address - Country:US
Practice Address - Phone:443-791-8593
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT6424225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist