Individual
CARLY GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
212 AMBER BEACH ROAD, MARIETTA, NY 13310
(315) 729-9056
Mailing address
212 AMBER BEACH ROAD, MARIETTA, NY 13310
(315) 729-9056
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
40QA01649600
NJ
Other
Enumeration date
12/18/2015
Last updated
02/04/2022
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