Organization
GRACE HOME TESTING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID WOLF (PRESIDENT)
(228) 863-3331
Entity
Organization
Contact information
Practice address
1120 BROAD AVE, GULFPORT, MS 39501-2414
(228) 863-3331
(228) 863-3392
Mailing address
1120 BROAD AVE, GULFPORT, MS 39501-2414
(228) 863-3331
(228) 863-3392
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
02/18/2013
Last updated
02/18/2013
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