Healthcare Provider Details

I. General information

NPI: 1346032224
Provider Name (Legal Business Name): GRACE ELSEN DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GRACE ROBISON DPT

II. Dates (important events)

Enumeration Date: 05/19/2025
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1407 E CHERRY ST
VERMILLION SD
57069-2602
US

IV. Provider business mailing address

9070 W CHEYENNE AVE STE 100
LAS VEGAS NV
89129-8935
US

V. Phone/Fax

Practice location:
  • Phone: 605-624-7246
  • Fax: 605-624-7177
Mailing address:
  • Phone: 702-268-7213
  • Fax: 702-818-5001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: