Organization
GRACE INTERNAL MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VANOSIA SHABLEE FAISON MD (CEO)
(334) 568-2335
Entity
Organization
Contact information
Practice address
102 MEDICAL CENTER DR STE F, PRATTVILLE, AL 36066-7286
(334) 568-2335
(334) 380-3567
Mailing address
102 MEDICAL CENTER DR STE F, PRATTVILLE, AL 36066-7286
(334) 568-2335
(334) 568-2336
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
11/30/2022
Last updated
06/12/2023
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