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NPI Code Detail

MEDICARE: MS. CHRISTA GRADY PT

MEDICARE: MS. CHRISTA GRADY PT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist10893OH
2225100000XPhysical Therapist002249WV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3P00223767OTHERRR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2000000217253OTHERANTHEM BCBS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
51659397826OTHERNPI

General Provider Information

NPI Number : 1659397826
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CHRISTA GRADY PT
Provider Business Mailing Address
First Line : 90 JACKSON PIKE
Second Line :
City : GALLIPOLIS
State : OH
Zip : 45631-1560
Country : US
Telephone Number : 740-446-5890
Fax Number : 740-446-5532
Provider Business Practice Location Address
First Line : 98 STATE ST
Second Line :
City : PROCTORVILLE
State : OH
Zip : 45669-8163
Country : US
Telephone Number : 740-886-9403
Fax Number : 740-446-5153
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2006
Last Update Date : 07/31/2007

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Directions to “ MS. CHRISTA GRADY PT” Practice Location

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