Individual
JACOB AARON GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1239 W BLUEGRASS RD, NIXA, MO 65714-8058
(417) 593-9801
Mailing address
1239 W BLUEGRASS RD, NIXA, MO 65714-8058
(417) 593-9801
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2020016991
MO
Other
Enumeration date
10/31/2022
Last updated
10/31/2022
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