Individual
TERENCE A GRADEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2200 BERGQUIST DR. SUITE 1, WILFORD HALL, LACKLAND, AFB, TX 78236
(210) 887-2123
Mailing address
2200 BERGQUIST DR. SUITE 1, WILFORD HALL, LACKLAND, AFB, TX 78236
(210) 887-2123
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
Other
Enumeration date
09/23/2011
Last updated
09/23/2011
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