National Provider Identifier

Shannon Grage, PT, DPT

Shannon Grage, PT, DPT is listed in the NPPES registry with a primary specialty of Orthopedic Physical Therapist in Brockport, NY and a listed phone number of (585) 275-5321.

NPI 1790496396Brockport, NYOrthopedic Physical Therapist

Profile Overview

NPI
1790496396
Provider Type
Individual
Primary Specialty
Orthopedic Physical Therapist
Enumeration Date
December 06, 2022
Last Updated
December 06, 2022

Practice Location

  • 156 West Ave
  • Brockport, NY 14420-1229

Phone: (585) 275-5321

Specialties

  • Orthopedic Physical Therapist (2251X0800X)
Full Record
NPI
1790496396
Entity Type
Individual
Last Name
Grage
First Name
Shannon
Credential
PT, DPT
Mailing Street Address
156 West Ave
Mailing City
Brockport
Mailing State
NY
Mailing ZIP Code
14420-1229
Mailing Country
US
Practice Street Address
156 West Ave
Practice City
Brockport
Practice State
NY
Practice ZIP Code
14420-1229
Practice Country
US
Practice Phone
(585) 275-5321
Enumeration Date
December 06, 2022
Last Updated
December 06, 2022
Sex
Female
Sole Proprietor
No
Certification Date
December 06, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Orthopedic Physical Therapist (2251X0800X)