Organization
UPRIVER MYOPRACTIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES COLIN GRADY LMT (LICENSED MASSAGE THERAPIST)
(208) 295-9500
Entity
Organization
Contact information
Practice address
31 EAST DAVIS STREET, SANTA, ID 83866-8386
(208) 295-9500
Mailing address
PO BOX 204, SANTA, ID 83866-0204
(208) 295-9500
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
—
—
Other
Enumeration date
02/11/2025
Last updated
02/11/2025
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