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Individual

MICHAEL GRADY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
8821 KNOEDL CT, LITTLE ROCK, AR 72205-4600
(501) 228-6303
Mailing address
3132 OVERCUP DR, SHERWOOD, AR 72120-3703
(501) 833-9869

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2166
LICENSE #
AR
Enumeration date
08/13/2006
Last updated
07/08/2007
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