| NPI | 1104691468 |
|---|---|
| Former Legal Business Name | SLIMMING GRACE LLC |
| Entity Type | Organization |
| Authorized Contact | DANNI OWENS Owner 928-279-5076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2023-11-16 |
| Last Update Date | 2023-11-16 |