Individual
CLYDE GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
104 S BROAD ST, KNOXVILLE, IL 61448-1339
(309) 289-2335
(309) 289-8196
Mailing address
104 S BROAD ST, KNOXVILLE, IL 61448-1339
(309) 289-2335
(309) 289-8196
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IL
Other
Enumeration date
10/02/2006
Last updated
07/08/2007
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