Provider Demographics
NPI:1821320409
Name:GRADY, SEAN P (DC)
Entity Type:Individual
Prefix:DR
First Name:SEAN
Middle Name:P
Last Name:GRADY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7920 MCDONOGH ROAD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5249
Mailing Address - Country:US
Mailing Address - Phone:410-356-9939
Mailing Address - Fax:410-356-9987
Practice Address - Street 1:7920 MCDONOGH RD
Practice Address - Street 2:SUITE 101
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5249
Practice Address - Country:US
Practice Address - Phone:410-356-9939
Practice Address - Fax:410-356-9987
Is Sole Proprietor?:No
Enumeration Date:2010-02-05
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03654111N00000X
MDS03654111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor