Individual
MARY ELIZABETH GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6828 BARDSTOWN RD, LOUISVILLE, KY 40291-3050
(502) 231-2020
Mailing address
PO BOX 207170, DALLAS, TX 75320-7170
(636) 200-4393
(636) 527-0766
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2349DT
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/01/2023
Last updated
01/16/2025
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