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General NPI Number Information
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NPI Number | 1902799489
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Entity Type | Individual
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Provider Name | KATHERINE GRACE ELY PT
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Gender | Female
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Dates
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Enumeration Date | 06/02/2025
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Last Update Date | 06/02/2025
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Provider Practice Location Address
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Address Line | 1014 GRANADA AVE
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City | NASHVILLE
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State | TN
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Zip | 37206-3443
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Country | US
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Telephone | 225-223-9045
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Fax |
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Provider Business Mailing Address
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Address Line | 1014 GRANADA AVE
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City | NASHVILLE
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State | TN
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Zip | 37206-3443
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Country | US
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Telephone | 225-223-9045
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number | 10961
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License Number State | TN
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