Individual
GRADY MADISON KUYKENDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
630 S MAIN ST, WATER VALLEY, MS 38965-3468
(662) 473-5947
Mailing address
711 AVIGNON DR, RIDGELAND, MS 39157-5120
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT6816
MS
Other
Enumeration date
02/26/2020
Last updated
02/26/2020
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