Individual provider · Type 1 NPI
Leslie Grady, P.A.
Medical Physician Assistant · Boulder, CO
NPI number
1114902640
Active
Practice location
2750 Broadway St
Boulder, CO 80304-3573
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 225 (CO) |
Medical Physician Assistant: Definition to come...
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About NPI 1114902640
Leslie Grady, P.A.'s National Provider Identifier is 1114902640, issued on Dec 7, 2005. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Boulder, CO. The record was last updated on Jul 13, 2026.