Individual
SAMANTHA ANNE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2686 W STATE ST, BRISTOL, TN 37620-1817
(423) 844-0026
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 952-2111
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
363A00000X
Physician Assistant
Primary
0110010426
VA
363A00000X
Physician Assistant
6247
TN
Other
Enumeration date
01/17/2018
Last updated
12/23/2025
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