# MOUNTAIN GRACE WOMEN'S WELLNESS CENTER LLC

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

## Provider details

- **NPI number:** 1326953969
- **Authorized official:** DEANNE DYSON FNP-BC (OWNER/PROVIDER)
- **Authorized official phone:** (304) 694-8474

## Contact information

- **Practice address:** 201 MERCHANT ST STE 1, FAIRMONT, WV 26554-4042
- **Practice address phone:** (304) 504-3994
- **Mailing address:** 354 HARBOR DR, MORGANTOWN, WV 26508-9227
- **Mailing address phone:** (304) 694-8474

## Taxonomy

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

## Other

- **Enumeration date:** 08/18/2026
- **Last updated:** 08/18/2026