Individual
BRIAN EDWARD GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
5188 BLISSFUL VALLEY CIR, LAS VEGAS, NV 89149-5262
(702) 373-9929
(800) 886-2862
Mailing address
5188 BLISSFUL VALLEY CIR, LAS VEGAS, NV 89149-5262
(702) 373-9929
(800) 886-2862
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA727
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002402144
—
NV
Enumeration date
09/28/2006
Last updated
12/11/2018
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