Individual
BEVERLY M GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 GROVE ST, SUITE 110, PITTSFORD, NY 14534-1300
(585) 703-4169
Mailing address
122 DEERHURST LN APT 4, WEBSTER, NY 14580-2708
(585) 872-9199
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
013313
NY
Other
Enumeration date
03/28/2007
Last updated
07/08/2007
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