Individual
MARK GRIDLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CCC-SLP
Contact information
Practice address
610 GREEVER TER, LAWRENCE, KS 66046-2861
(785) 766-4384
Mailing address
610 GREEVER TER, LAWRENCE, KS 66046-2861
(785) 766-4384
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
3110
KS
Other
Enumeration date
12/31/2010
Last updated
12/31/2010
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