Healthcare Provider Details

I. General information

NPI: 1033029384
Provider Name (Legal Business Name): GRACE DELMARE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1615 E CAPITOL WAY
BISMARCK ND
58501-2218
US

IV. Provider business mailing address

1615 E CAPITOL WAY
BISMARCK ND
58501-2218
US

V. Phone/Fax

Practice location:
  • Phone: 701-751-0410
  • Fax:
Mailing address:
  • Phone: 701-751-0410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2969
License Number StateND

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: