Individual
TRISTA T GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1282 SEWELL ST S, RAINELLE, WV 25962-7140
(304) 661-0657
Mailing address
1282 SEWELL ST S, RAINELLE, WV 25962-7140
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/08/2021
Last updated
02/08/2021
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