Grace G Crook, DPT | |
3125 Valencia Dr, Idaho Falls, ID 83404-7575 | |
(208) 529-3332 | |
Not Available |
Full Name | Grace G Crook |
---|---|
Gender | Female |
Speciality | Physical Therapist |
Location | 3125 Valencia Dr, Idaho Falls, Idaho |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1053185413 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | PENDING (Idaho) | Primary |
Provider Name | Performance Therapy, Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1427375724 PECOS PAC ID: 8426189648 Enrollment ID: O20100701000223 |
Mailing Address | Practice Location Address |
---|---|
Grace G Crook, DPT 3125 Valencia Dr, Idaho Falls, ID 83404-7575 Ph: (208) 529-3332 | Grace G Crook, DPT 3125 Valencia Dr, Idaho Falls, ID 83404-7575 Ph: (208) 529-3332 |
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