Wallace, Grace
Wallace, Grace is an individual health care provider with primary practice located at 711 Greenbrier Creek Road , Fort Gay WV 25514. She recently has only one registered license in Nursing Service Related Providers / Personal Care Attendant, which is considered as her primary health care specialty. Wallace, Grace can be contacted via phone (304) 356-4562.Contact Information
Primary practice address
711 Greenbrier Creek Road
Fort Gay WV 25514
Phone: (304) 356-4562
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Related Providers / Personal Care Attendant | 3747P1801X |
Profile Details
| NPI number | 1154836401 |
|---|---|
| LBN Legal business name | Wallace, Grace |
| Credentials | PCA |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 8th, 2017 |
| Last updated | Dec 8th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1154836401 | NPPES |
| Other | 3810006088 | PROVIDER ID |
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