Individual
MR. LARRY J GRAHAM JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1284 MAURER AVE, PONTIAC, MI 48342-1960
(248) 252-1427
Mailing address
1225 E BIG BEAVER RD, TROY, MI 48083-1905
(248) 524-8801
(248) 524-8850
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/01/2019
Last updated
10/01/2019
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