Individual
JAMES COLIN GRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
31 EAST DAVIS STREET, SANTA, ID 83866
(208) 295-9500
Mailing address
PO BOX 204, SANTA, ID 83866-0204
(208) 295-9500
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MAS-4960
ID
225700000X
Massage Therapist
MAS4960
ID
Other
Enumeration date
01/31/2025
Last updated
01/31/2025
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