NPI | 1932708617 |
---|---|
Doing Business As | GRACELAND FAMILY PRACTICE |
Entity Type | Organization |
Authorized Contact | DEBRA ANN FICKLING Provider 850-741-2878 |
Organization Subpart ? | No |
Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
Enumeration Date | 2020-10-22 |
Last Update Date | 2020-10-22 |