Healthcare Provider Details

I. General information

NPI: 1174468987
Provider Name (Legal Business Name): GRACE C SANCHEZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4126 N 49TH DR
PHOENIX AZ
85031-2320
US

IV. Provider business mailing address

4126 N 49TH DR
PHOENIX AZ
85031-2320
US

V. Phone/Fax

Practice location:
  • Phone: 480-791-5195
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number25311
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: