Organization
GRACE MOUNTAIN MEDICAL, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA RENEE SHEPHERD HATFIELD APRN (CO-OWNER)
(606) 226-8677
Entity
Organization
Contact information
Practice address
115 LEE AVE STE 101, PIKEVILLE, KY 41501-2047
(606) 727-5296
Mailing address
1235 SALTLICK RD, HUEYSVILLE, KY 41640-6653
(606) 226-8677
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
08/23/2019
Last updated
11/14/2024
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