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Individual

MR. COLIN BRAD GRAHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.T.R.

Contact information

Practice address
1903 CRESTHAVEN DR, AUSTIN, TX 78704-2754
(512) 318-8342
Mailing address
1903 CRESTHAVEN DR, AUSTIN, TX 78704-2754
(512) 318-8342

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
110887
TX

Other

Enumeration date
09/27/2013
Last updated
09/27/2013
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