Individual
GRACE EDMUNDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1311
(304) 974-5000
Mailing address
4605 MACCORKLE AVE SW, SOUTH CHARLESTON, WV 25309-1311
(304) 974-5000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2878
WV
Other
Enumeration date
09/20/2021
Last updated
02/21/2025
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