Individual
GRADY DOUGLAS TESTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1312 OLD MOUNT DORA RD, EUSTIS, FL 32726-7946
(352) 250-4974
Mailing address
PO BOX 465, PAISLEY, FL 32767-0465
(352) 250-4974
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
374U00000X
Home Health Aide
—
—
Other
Enumeration date
12/21/2022
Last updated
12/21/2022
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