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1255050084
GRACEVINE HEALTHCARE SVCS A PROFESSNAL NURSING CORP
SAN BERNARDINO, CA
NPI
1255050084
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Entity Type
Organization
Authorized Contact
OLUWAYEMISI DARAMOLA
Owner
909-743-1300
Organization Subpart ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner, Family
Enumeration Date
2022-08-24
Last Update Date
2023-10-02
Business Address
GRACEVINE HEALTHCARE SVCS A PROFESSNAL NURSING CORP
473 E CARNEGIE DR STE 200
SAN BERNARDINO, CA 92408-4201
Phone number: 909-743-1300
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Mailing Address
GRACEVINE HEALTHCARE SVCS A PROFESSNAL NURSING CORP
473 E CARNEGIE DR STE 200
SAN BERNARDINO, CA 92408
Phone number: 909-743-1300
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