Individual
GRADY GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
413 N 2ND ST, BOONEVILLE, MS 38829-2031
(662) 480-4006
Mailing address
1200 CORPORATE DR STE 400, HOOVER, AL 35242-5424
(423) 777-6236
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7836
MS
Other
Enumeration date
09/06/2024
Last updated
09/06/2024
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