RANDALL GRACE

HAZARD, KY
NPI1073057410
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date2016-12-05
Last Update Date2016-12-05
Business Address
-- RANDALL GRACE
48 INDEPENDENCE DR
HAZARD, KY 41701-9443
Phone number: 606-487-1646
Mailing Address
-- RANDALL GRACE
48 INDEPENDENCE DR
HAZARD, KY 41701-9443
Phone number: 606-487-1646