Organization
FULL POTENTIAL LIFE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOGAN GRADDY M.D. (PSYCHIATRIST)
(919) 321-6171
Entity
Organization
Contact information
Practice address
1530 N GREGSON ST, SUITE 3-D, DURHAM, NC 27701-1155
(919) 321-6171
(888) 805-6175
Mailing address
1530 N GREGSON ST, SUITE 3-D, DURHAM, NC 27701-1155
(919) 321-6171
(888) 805-6175
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
07/16/2009
Last updated
07/16/2009
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