Individual
NORMAN GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
115 HUNTINGTON PARK DR, FAYETTEVILLE, GA 30214-7720
(917) 567-3141
Mailing address
175 THISTLEWOOD LN, FAYETTEVILLE, GA 30214-2325
(917) 567-3141
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/02/2019
Last updated
09/29/2021
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