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1700201019
BRAY GRUNDY
KENOSHA, WI
NPI
1700201019
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: WI 1255724)
Enumeration Date
2014-02-24
Last Update Date
2014-02-24
Business Address
-- BRAY GRUNDY DPT
3415 SHERIDAN RD
KENOSHA, WI 53140-1924
Phone number: 262-657-6175
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Mailing Address
-- BRAY GRUNDY DPT
12709 W WAKEFIELD DR
BEACH PARK, IL 60083-3021
Phone number:
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