Individual
MADELINE MARIE GRIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
1502 N JEFFERSON ST, CARROLLTON, MO 64633-1948
(660) 542-1664
Mailing address
27175 PVT 275, CARROLLTON, MO 64633-6416
(660) 542-1713
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
112898
MO
Other
Enumeration date
05/14/2007
Last updated
07/08/2007
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