Organization
GRACE COMMUNITY HEALTH LLC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISTY BLALOCK NP (PRESIDENT)
(903) 717-8712
Entity
Organization
Contact information
Practice address
2001 W FERGUSON RD, SUITE 1000, MT PLEASANT, TX 75455-2925
(903) 717-8712
Mailing address
2001 W FERGUSON RD, SUITE 1000, MT PLEASANT, TX 75455-2925
(903) 717-8712
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/25/2012
Last updated
09/25/2012
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