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Individual
MARK D GRATTON
Active
Individual
MARK D GRATTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
070-013475
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070-013475
ILLINOIS PT LICENSE NUMBE
IL
Enumeration date
05/28/2006
Last updated
04/11/2012
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