Individual
KYLE ALTON GRAYHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3001 MAY APPLE DR, HARRISON, AR 72601-5799
(870) 321-5339
Mailing address
3001 MAY APPLE DR, HARRISON, AR 72601-5799
(870) 321-5339
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
123456
AR
Other
Enumeration date
09/30/2019
Last updated
09/30/2019
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