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Grace Nicole Shutz

Physical Therapist in Belleville, IL. Individual provider (NPI-1).

NPI number1619702073
StatusActive
Last updated in NPPESSep 5, 2024

Details

NPI
1619702073
Entity type
Individual (NPI-1)
Name
Grace Nicole Shutz
Sex
Female
Sole proprietor
No
Enumeration date
Sep 5, 2024
Certification date
Sep 5, 2024
Last updated
Sep 5, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical Therapist070.028593ILYes

Practice location

2346 Mascoutah Ave
Belleville, IL 62220-3586

Phone 618-277-6282

Mailing address

723 Shenandoah Ave
Saint Louis, MO 63104-4152

Phone 773-225-8904

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