Individual
GRACE G DESANTIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3410 CHAPARRAL DR APT 133, ROANOKE, VA 24018-4930
(717) 719-1658
Mailing address
213 S JEFFERSON ST, STE 625, ROANOKE, VA 24011-1713
(717) 719-1658
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/12/2020
Last updated
09/27/2024
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