Provider Demographics
NPI:1336665462
Name:GRADY, MEREDITH ELLEN (PT, DPT)
Entity Type:Individual
Prefix:MS
First Name:MEREDITH
Middle Name:ELLEN
Last Name:GRADY
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 BEL AIR RD STE C3
Mailing Address - Street 2:
Mailing Address - City:FALLSTON
Mailing Address - State:MD
Mailing Address - Zip Code:21047-2703
Mailing Address - Country:US
Mailing Address - Phone:443-417-2499
Mailing Address - Fax:443-981-2611
Practice Address - Street 1:2315 BEL AIR RD STE C3
Practice Address - Street 2:
Practice Address - City:FALLSTON
Practice Address - State:MD
Practice Address - Zip Code:21047-2703
Practice Address - Country:US
Practice Address - Phone:443-417-2499
Practice Address - Fax:443-981-2611
Is Sole Proprietor?:No
Enumeration Date:2017-08-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD26615225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist