Individual
GRACE BURDETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4510 PENNSYLVANIA AVE STE C, CHARLESTON, WV 25302-4835
(304) 965-9081
(304) 471-2488
Mailing address
1205 MOORE AVE APT 13, DUNBAR, WV 25064-2521
(304) 410-8345
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
07/23/2025
Last updated
07/23/2025
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