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Individual

CHARLES M GRAHAM JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
SA

Contact information

Practice address
1069 W BROAD ST, SUITE 908, FALLS CHURCH, VA 22046-4610
(540) 239-4852
Mailing address
5119 PRESTWICK DR, FAIRFAX, VA 22030-4537
(540) 239-4852

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary

Other

Enumeration date
05/30/2012
Last updated
05/30/2012
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