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Contact Information

GRACEFUL AGING,PC
2732 BARDOLINO DR
FAYETTEVILLE, NC28306-4636
 Phone: 910-868-6477
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for GRACEFUL AGINGPC · (Female)

NPI Number 1316259013
Status Active
Credentials
Entity Individual
Enumeration date 07/09/2010
Last updated 07/09/2010 - About 16 years ago
Sole proprietor 1 Not specified
Identifiers
  • NC License # 200601059
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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