Individual
SCOTT LEE GRADBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
135 SOUTH GIBSON ST, MEDFORD, WI 54451-1622
(715) 748-8100
(715) 748-8199
Mailing address
135 S GIBSON ST, MEDFORD, WI 54451-1622
(715) 748-8100
(715) 748-8199
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
047894
WI
Other
Enumeration date
10/03/2006
Last updated
07/10/2007
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