Organization
NICOLE GRAHAM
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHETAN AMIN D.O. (OFFICE MANAGER/OWNER)
(704) 636-5626
Entity
Organization
Contact information
Practice address
1401 W INNES ST, SALISBURY, NC 28144-2574
(704) 636-5626
(704) 636-5641
Mailing address
1401 W INNES ST, SALISBURY, NC 28144-2574
(704) 636-5626
(704) 636-5641
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
0010-07063
NC
314000000X
Skilled Nursing Facility
0010-07063
NC
Other
Enumeration date
02/09/2017
Last updated
02/10/2017
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