Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
GRADY CONGLETON
Active Sole ProprietorGRADY CONGLETON is a Athletic Trainer healthcare provider located in EAST HAMPTON, New York. NPI 1205264033 is currently active in the NPPES registry. Verify at CMS.
Athletic Trainer · EAST HAMPTON, NY
Registration Details
- NPI Number
- 1205264033
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Oct 14, 2013 (12.852635781244 yrs)
- Last Updated
- Oct 14, 2013
- Licenses
-
002583 (NY)2451 (MA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
18 GOODFRIEND DREAST HAMPTON, NY, 119372584Browse NY providers · Browse ZIP 11937
- Phone
- 6319075000
- Primary Specialty
-
Athletic Trainer
2255A2300X
- Additional Specialty
- Athletic Trainer
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.