Individual
GRADY ERNST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2542 SE WELSH ST, PORT ST LUCIE, FL 34984-5240
(484) 571-4111
Mailing address
2542 SE WELSH ST, PORT ST LUCIE, FL 34984-5240
(484) 571-4111
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
28767
FL
Other
Enumeration date
02/06/2023
Last updated
02/06/2023
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