Individual
BENJAMIN GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10158 LAKER LN, ALLENDALE, MI 49401-8917
(517) 974-2517
Mailing address
10158 LAKER LN, ALLENDALE, MI 49401-8917
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
MI
Other
Enumeration date
01/18/2017
Last updated
01/18/2017
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