Individual
MS. MARIE GRACE NOAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-4677
Mailing address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-4677
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2464
NE
Other
Enumeration date
02/04/2020
Last updated
10/11/2024
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