| NPI | 1669062899 |
|---|---|
| Other Name | GRACE FAMILY MEDICINE |
| Entity Type | Organization |
| Authorized Contact | DAVID CHARLES TERRELL A RN P 386-287-2111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Enumeration Date | 2021-01-21 |
| Last Update Date | 2024-08-13 |