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Individual

DR. SUSAN MARIE GRADY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
7900 SHELBYVILLE RD, STE. A15, LOUISVILLE, KY 40222-5451
(502) 327-8568
(502) 327-0613
Mailing address
7900 SHELBYVILLE RD, STE. A15, LOUISVILLE, KY 40222-5451
(502) 327-8568
(502) 327-0613

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1277DT
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
77012771
KY
01
P00805798
RR MEDICARE
KY
Enumeration date
03/17/2007
Last updated
04/23/2010
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