Individual
RUSTY LYNN GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4301 W MARKHAM ST, LITTLE ROCK, AR 72205-7101
(501) 686-6120
Mailing address
4301 W MARKHAM ST # 744, LITTLE ROCK, AR 72205-7101
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA1309
AR
Other
Enumeration date
03/05/2021
Last updated
03/12/2021
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