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Individual

CHARLES LEON GRAVES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
530 E 34TH ST, SUITE 201, JOPLIN, MO 64804-3924
(417) 347-7550
(417) 347-7560
Mailing address
PO BOX 2526, JOPLIN, MO 64803-2526
(417) 347-7600
(417) 347-7608

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
116521
MO

Other

Enumeration date
10/29/2006
Last updated
07/08/2007
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