Individual
TABITHA A GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1775 BROKEN ARROW CREEK RD, RIVERSIDE, AL 35135-2006
(205) 382-4774
Mailing address
1775 BROKEN ARROW CREEK RD, RIVERSIDE, AL 35135-2006
(205) 382-4774
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/12/2016
Last updated
09/12/2016
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