Individual
MRS. MARCY RENEE GRACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
1220 RICHMOND RD, IRVINE, KY 40336-7232
(606) 723-5315
Mailing address
704 QUAIL RUN RD, IRVINE, KY 40336-9355
(606) 723-9837
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
380101061152933
KY
Other
Enumeration date
05/19/2008
Last updated
05/19/2008
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