# GRACEOL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306373188
- **Authorized official:** MRS. YEMI J. SOWEMIMO FNP-C (OWNER)
- **Authorized official phone:** (404) 839-2688

## Contact information

- **Practice address:** 1035 HONEY CREEK RD, CONYERS, GA 30013
- **Practice address phone:** (404) 839-2688
- **Practice address fax:** (770) 922-9498
- **Mailing address:** 1035 HONEY CREEK ROAD, CONYERS, GA 30013
- **Mailing address phone:** (404) 839-2688
- **Mailing address fax:** (770) 922-9498

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QA0505X | Adult Medicine Physician | — | NULL | Yes |
| 207QA0505X | Adult Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 05/11/2017
- **Last updated:** 07/21/2022