Individual
MRS. KATRINA MARIE GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2 WICKERSHAM ST, MANGUM, OK 73554-9117
(580) 782-3337
(580) 782-3339
Mailing address
2 WICKERSHAM ST, MANGUM, OK 73554-9117
(580) 782-3337
(580) 782-3339
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/03/2007
Last updated
10/03/2007
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