Organization
LITTLE LEGENDS PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARTIE J GRAVITT MD (OWNER)
(417) 699-8682
Entity
Organization
Contact information
Practice address
169 W HIGH ST, MOUNT GILEAD, OH 43338-1214
(419) 751-7050
(740) 513-4628
Mailing address
169 W HIGH ST, MOUNT GILEAD, OH 43338-1214
(419) 751-7050
(740) 513-4628
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Enumeration date
01/09/2024
Last updated
01/09/2024
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