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Individual

MR. BRADY PERRY GRIFFITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
500 S MAPLE ST, WACONIA, MN 55387-1752
(952) 442-2191
(952) 442-6537
Mailing address
8959 PARTRIDGE RD, SAINT BONIFACIUS, MN 55375-1320

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12320
MN
363AM0700X
Medical Physician Assistant
12320
MN

Other

Enumeration date
11/09/2016
Last updated
05/19/2023
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