Grace Brack | Middletown, NY • PECOS Search

Grace Brack

Specialist

Other Service Providers

2277 Goshen Tpke, Middletown, NY 10941-4032

PECOS Enrollment

Based on the most recent information from CMS, provider Grace Brack does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1619372984
Provider Type
Individual
Full Name
Brack, Grace
Credential
COTA

Gender
Female
Sole Proprietor
No
Enumeration Date
10/29/2014
Last Updated
10/29/2014

Contact Information

Practice Location

2277 Goshen Tpke, Middletown, NY 10941-4032

Unlisted Fax

Mailing Location

2277 Goshen Tpke, Middletown, NY 10941-4032

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 174400000X Primary	Description Specialist Other Service Providers	License 008505-1 New York