Organization
GRADAM MEN'S HEALTH TESTOSTERONE CLINIC LLC
Active
Other names
Gradam Dispatching Services LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLIE O IMONAH APRN, DNP, FNP (MEDICAL DIRECTOR)
(401) 599-3737
Entity
Organization
Contact information
Practice address
225 NEWMAN AVE, RUMFORD, RI 02916-1218
(401) 599-3737
(401) 409-5545
Mailing address
225 NEWMAN AVE, RUMFORD, RI 02916-1218
(401) 599-3737
(401) 409-5545
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
01/20/2025
Last updated
01/20/2025
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