Individual
CANDICE LAUREN GRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1025 TRILLIUM DR, CONWAY, AR 72034-7563
(662) 415-9717
Mailing address
1025 TRILLIUM DR, CONWAY, AR 72034-7563
(662) 415-9717
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT4788
MS
225100000X
Physical Therapist
Primary
PT4929
AR
Other
Enumeration date
11/02/2012
Last updated
05/28/2024
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