Individual
ASHLEY GRADY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
279 NW CALIFORNIA BLVD, PORT ST LUCIE, FL 34986-2505
(772) 301-0838
Mailing address
PO BOX 882294, PORT ST LUCIE, FL 34988-2294
(772) 985-1611
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
28706
FL
Other
Enumeration date
09/19/2018
Last updated
09/19/2018
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