| NPI | 1467020891 |
|---|---|
| Doing Business As | WILLOW GRACE WELLNESS CENTER LLC |
| Entity Type | Organization |
| Authorized Contact | TANGIE MARTIN MACON Therapitst 205-613-0764 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Enumeration Date | 2021-06-13 |
| Last Update Date | 2021-06-13 |