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Organization
GRACEOL CORPORATION
Active
Organization
GRACEOL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. YEMI J. SOWEMIMO FNP-C (OWNER)
(404) 839-2688
Entity
Organization
Contact information
Practice address
1035 HONEY CREEK RD, CONYERS, GA 30013
(404) 839-2688
(770) 922-9498
Mailing address
1035 HONEY CREEK ROAD, CONYERS, GA 30013
(404) 839-2688
(770) 922-9498
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
—
NULL
207QA0505X
Adult Medicine Physician
Primary
—
—
Other
Enumeration date
05/11/2017
Last updated
07/21/2022
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