| Graceway Direct | |
|
5807 Hasbrook Dr Louisville KY 40229-2984 | |
| (502) 709-0590 | |
| Not Available |
| Full Name | Graceway Direct |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 5807 Hasbrook Dr, Louisville, Kentucky |
| Authorized Official Name and Position | Lori Williams (OWNER) |
| Authorized Official Contact | 5027090590 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Graceway Direct 5807 Hasbrook Dr Louisville KY 40229-2984 | Graceway Direct 5807 Hasbrook Dr Louisville KY 40229-2984 Ph: (502) 709-0590 |
| NPI Number | 1689255127 |
|---|---|
| Provider Enumeration Date | 04/16/2021 |
| Last Update Date | 04/16/2021 |
| Certification Date | 04/16/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689255127 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (NU) | Primary |
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