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Individual

GRADY MICHAEL HAYES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
OTRL

Contact information

Practice address
86 VALLEY HIDEAWAY DR, HAYESVILLE, NC 28904-9674
(828) 389-9941
(828) 389-3712
Mailing address
1079 NOTTELY DAM RD, BLAIRSVILLE, GA 30512-1798
(912) 253-8718

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
7464
NC
225X00000X
Occupational Therapist
OT002619
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000978865
GA
Enumeration date
12/30/2006
Last updated
06/29/2012
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