Individual
MRS. SHELLEY MONTINA GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
400 RANGER ST, HEREFORD, TX 79045-2812
(806) 364-0669
Mailing address
17251 LAGUNA VISTA RD, AMARILLO, TX 79119-7740
(806) 499-3766
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2040400
TX
Other
Enumeration date
12/17/2012
Last updated
12/17/2012
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