Individual
GRACE ROCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
902 JACOBS RUN RD, SALEM, WV 26426-8417
(304) 476-9914
Mailing address
902 JACOBS RUN RD, SALEM, WV 26426-8417
(304) 476-9914
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/05/2024
Last updated
01/05/2024
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