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General NPI Number Information
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NPI Number | 1164313284
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Entity Type | Individual
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Provider Name | GRACE WILSON DACM, MAOM, L.AC
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Gender | Female
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Dates
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Enumeration Date | 07/15/2025
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | 247 CHARLOTTE ST # R3
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City | ASHEVILLE
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State | NC
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Zip | 28801-1466
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Country | US
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Telephone | 804-239-7362
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Fax |
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Provider Business Mailing Address
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Address Line | 61 PINNACLE PARK RD
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City | WEAVERVILLE
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State | NC
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Zip | 28787-9228
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Country | US
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Telephone | 828-545-0512
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 2155
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License Number State | NC
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