Individual
EDWARD GRADMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
430 N MONTE VISTA ST, ADA, OK 74820-4610
(580) 332-2323
Mailing address
1710 W 3RD ST STE 100, ELK CITY, OK 73644-5160
(703) 295-9360
(703) 766-9725
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041368366
IL
367500000X
Certified Registered Nurse Anesthetist
Primary
209012356
IL
Other
Enumeration date
12/24/2014
Last updated
08/30/2022
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