| Full Potential Life Llc | |
|
1530 N Gregson St Suite 3-d Durham NC 27701-1155 | |
| (919) 321-6171 | |
| (888) 805-6175 |
| Full Name | Full Potential Life Llc |
|---|---|
| Speciality | Clinic/center - Adult Mental Health |
| Location | 1530 N Gregson St, Durham, North Carolina |
| Authorized Official Name and Position | Logan Graddy (PSYCHIATRIST) |
| Authorized Official Contact | 9193216171 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Full Potential Life Llc 1530 N Gregson St Suite 3-d Durham NC 27701-1155 Ph: (919) 321-6171 | Full Potential Life Llc 1530 N Gregson St Suite 3-d Durham NC 27701-1155 Ph: (919) 321-6171 |
| NPI Number | 1568692127 |
|---|---|
| Provider Enumeration Date | 07/16/2009 |
| Last Update Date | 07/16/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568692127 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary |
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