Individual
GRACE MULLEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
641 TRACEY JEAN CT, TRACY, CA 95377-8685
(209) 640-7414
Mailing address
641 TRACEY JEAN CT, TRACY, CA 95377-8685
(209) 640-7414
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
397003708
CA
Other
Enumeration date
08/16/2016
Last updated
08/16/2016
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