Organization
GRACEFUL WELLNESS AND MED SPA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA NICHOLS APRN (CEO)
(913) 608-9450
Entity
Organization
Contact information
Practice address
11030 OAKMONT ST STE 100, OVERLAND PARK, KS 66210-1120
(913) 608-9450
Mailing address
11030 OAKMONT ST STE 100, OVERLAND PARK, KS 66210-1120
(913) 608-9450
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
12/03/2024
Last updated
12/03/2024
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