Individual
DR. KELLY LEIGH GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
113 N PLAZA CT, VAN BUREN, AR 72956-2269
(479) 474-7878
(479) 471-1476
Mailing address
113 N PLAZA CT, VAN BUREN, AR 72956-2269
(479) 474-7878
(479) 471-1476
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2380
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
171400722
—
AR
Enumeration date
01/16/2006
Last updated
05/15/2024
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