Individual
ANTHONY GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2340 KNOB CREEK RD STE 704, JOHNSON CITY, TN 37604-2977
(423) 929-9101
(423) 434-2032
Mailing address
2340 KNOB CREEK RD STE 704, JOHNSON CITY, TN 37604-2977
(423) 929-9101
(423) 434-2032
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
64473
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/30/2017
Last updated
06/07/2022
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