Organization
BGRACEFUL LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LATOYA M CARSTARPHEN (OWNER/NP)
(205) 941-6099
Entity
Organization
Contact information
Practice address
1401 DOUG BAKER BLVD STE 107566, HOOVER, AL 35242-4974
(205) 941-6099
(205) 303-3166
Mailing address
1401 DOUG BAKER BLVD STE 107566, HOOVER, AL 35242-4974
(205) 941-6099
(205) 303-3166
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
12/18/2020
Last updated
12/18/2020
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