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Organization

GRACE SERVICES, LLC

Active
Other names
Grace Health Services
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GORDON E COBURN APRN-BC (OWNER)
(423) 283-4958
Entity
Organization

Contact information

Practice address
2 WORTH CIR, SUITE 2, JOHNSON CITY, TN 37601-4306
(423) 283-4958
(423) 283-7135
Mailing address
2 WORTH CIR, SUITE 2, JOHNSON CITY, TN 37601-4306
(423) 283-4958
(423) 283-7135

Taxonomy

Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
11054
TN

Other

Enumeration date
04/10/2014
Last updated
04/10/2014
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