Provider Demographics
NPI:1215741269
Name:JONASSON, GRACE MOORE (DC)
Entity type:Individual
Prefix:
First Name:GRACE
Middle Name:MOORE
Last Name:JONASSON
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:GRACE
Other - Middle Name:ELIZABETH
Other - Last Name:MOORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:101 BURLER ST
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-1285
Mailing Address - Country:US
Mailing Address - Phone:336-906-7754
Mailing Address - Fax:
Practice Address - Street 1:833 JULIAN AVE
Practice Address - Street 2:
Practice Address - City:THOMASVILLE
Practice Address - State:NC
Practice Address - Zip Code:27360-5848
Practice Address - Country:US
Practice Address - Phone:336-476-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-01
Last Update Date:2025-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5866111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor