Individual
MICHAEL GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
2701 CHESTNUT STATION CT, LOUISVILLE, KY 40299-6395
(800) 335-1060
Mailing address
720 HARRINGTON DR, LAFAYETTE, IN 47909-6281
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31003470A
IN
Other
Enumeration date
07/19/2015
Last updated
07/19/2015
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