Individual
MATTHEW WESTON GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
2209 W 25TH ST UNIT 1, SAN PEDRO, CA 90732-4147
(310) 345-5569
(310) 935-7992
Mailing address
2209 W 25TH ST UNIT 1, SAN PEDRO, CA 90732-4147
(310) 345-5569
(310) 935-7992
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
22809
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22809
CALIFORNIA MASSAGE THERAPY COUNCIL
CA
Enumeration date
11/23/2023
Last updated
11/27/2023
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