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1104402338
TABATHA GRACE
SHOW LOW, AZ
NPI
1104402338
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
(Licence: AZ 254322)
Enumeration Date
2021-03-18
Last Update Date
2023-03-09
Business Address
TABATHA GRACE
1500 S WHITE MOUNTAIN RD BLDG 3
SHOW LOW, AZ 85901-7111
Phone number: 928-532-5838
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Mailing Address
TABATHA GRACE
1300 S MAIN ST
SNOWFLAKE, AZ 85937-5661
Phone number: 928-536-5525
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