Individual
GRACE L KELSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
9142 CLUBHOUSE DR, RIVERDALE, GA 30274
(404) 747-2575
Mailing address
9142 CLUBHOUSE DR, RIVERDALE, GA 30274-4644
(404) 747-2575
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
87808
GA
Other
Enumeration date
06/08/2017
Last updated
07/21/2022
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