Individual
LAUREL GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
3119 W LAWN AVE, TAMPA, FL 33611-1926
(813) 831-7605
Mailing address
3119 W LAWN AVE, TAMPA, FL 33611-1926
(813) 831-7605
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA0013298
FL
Other
Enumeration date
03/23/2013
Last updated
03/23/2013
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