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NPI Code Detail

MEDICARE: GRACE KIRSCH

MEDICARE: GRACE KIRSCH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist008789AZ
2225X00000XOccupational TherapistAZ

General Provider Information

NPI Number : 1831831759
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRACE KIRSCH
Provider Business Mailing Address
First Line : 240 W OSBORN RD UNIT 5046
Second Line :
City : PHOENIX
State : AZ
Zip : 85013-3963
Country : US
Telephone Number : 952-818-4513
Fax Number :
Provider Business Practice Location Address
First Line : 3200 E GLENROSA AVE
Second Line :
City : PHOENIX
State : AZ
Zip : 85018-3911
Country : US
Telephone Number : 952-818-4513
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2022
Last Update Date : 04/10/2024

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Directions to “ GRACE KIRSCH ” Practice Location

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