NPI | 1043254360 |
---|---|
Doing Business As | GRACE FAMILY PRACTICE |
Entity Type | Organization |
Authorized Contact | MARK PICKETT VP 478-405-0280 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine |
Enumeration Date | 2006-06-16 |
Last Update Date | 2007-08-29 |