Individual
BONNIE GRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1115 N IMPERIAL AVE, EL CENTRO, CA 92243-1739
(760) 336-4649
Mailing address
1115 N IMPERIAL AVE, EL CENTRO, CA 92243-1739
(760) 336-4649
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
232636
CA
Other
Enumeration date
03/12/2013
Last updated
03/12/2013
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