Individual
GRACE GWINN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
1500 BLAZER BLVD, ASHLAND, KY 41102-5606
(304) 633-5853
Mailing address
108 WOODFIELD DR, MILTON, WV 25541-1055
(304) 633-5853
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/14/2017
Last updated
09/04/2020
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