Individual
MS. ANNETTE RUTH GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1 ELIZABETH PL, STE. D, DAYTON, OH 45417-3445
(937) 222-2233
(937) 222-9665
Mailing address
73 LINDEN AVE, DAYTON, OH 45403-1934
(937) 401-9120
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
50002335
OH
Other
Enumeration date
08/07/2012
Last updated
08/07/2012
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