Individual
MRS. AMY MELISSA GRAVES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OTRL
Contact information
Practice address
11517 KANIS RD, LITTLE ROCK, AR 72211-3724
(501) 993-7171
(501) 223-8075
Mailing address
8 WINONA DR, MAUMELLE, AR 72113-6301
(501) 658-8871
(501) 803-3641
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
OTR1609
AR
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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