Individual
CARRIE RAGAN GRAVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
424 W JAMES LEE BLVD, CRESTVIEW, FL 32536-2638
(850) 689-2260
(850) 398-6211
Mailing address
424 W JAMES LEE BLVD, CRESTVIEW, FL 32536-2638
(850) 689-2260
(850) 398-6211
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
EO1048
FL
247200000X
Other Technician
Primary
FS866660
FL
Other
Enumeration date
02/03/2010
Last updated
02/03/2010
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