Organization
GRACE KLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDDYSON OKHIHAN (CEO)
(919) 884-6191
Entity
Organization
Contact information
Practice address
6516 FALLS OF NEUSE RD, 110, RALEIGH, NC 27615-6847
(919) 884-6191
Mailing address
6516 FALLS OF NEUSE RD, 110, RALEIGH, NC 27615-6847
(919) 884-6191
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
01/27/2017
Last updated
01/27/2017
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