Individual
CASSANDRA R GRACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
178 HORNSBY CT, OZARK, AL 36360-4100
(334) 400-3745
Mailing address
178 HORNSBY CT, OZARK, AL 36360-4100
(334) 400-3745
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
2-064711
AL
Other
Enumeration date
09/26/2022
Last updated
09/29/2022
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