Individual
KANISHA GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6237 PRESIDENTIAL CT STE 140, FORT MYERS, FL 33919-3508
(877) 202-3530
(877) 772-5877
Mailing address
6237 PRESIDENTIAL CT STE 140, FORT MYERS, FL 33919-3508
(877) 202-3530
(877) 772-5877
Taxonomy
Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
—
—
Other
Enumeration date
05/23/2022
Last updated
05/23/2022
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