Individual
GRACE SONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1450 E VALLEY RD, SUITE 201, BASALT, CO 81621-8304
(970) 927-8611
(970) 927-8633
Mailing address
401 CASTLE CREEK RD, SUITE 2100, ASPEN, CO 81611-1159
(970) 925-4141
(970) 927-8633
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
09/18/2008
Last updated
10/04/2013
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