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Individual

MR. GRADY STANTON HALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
R.N.

Contact information

Practice address
53025 AVENIDA NAVARRO, LA QUINTA, CA 92253-5406
(760) 771-3008
Mailing address
53025 AVENIDA NAVARRO, LA QUINTA, CA 92253-5406
(760) 771-3008

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN 512918
CA

Other

Enumeration date
01/23/2008
Last updated
01/23/2008
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