Provider Demographics
NPI:1821426552
Name:PARSONS, GRACE
Entity Type:Individual
Prefix:DR
First Name:GRACE
Middle Name:
Last Name:PARSONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9712 SPENCER RD
Mailing Address - Street 2:
Mailing Address - City:LE ROY
Mailing Address - State:WV
Mailing Address - Zip Code:25252-7047
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9712 SPENCER RD
Practice Address - Street 2:
Practice Address - City:LE ROY
Practice Address - State:WV
Practice Address - Zip Code:25252-7047
Practice Address - Country:US
Practice Address - Phone:304-532-8894
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-15
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0008225183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist