Individual
LISA MICHELLE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
815 N LONG ST, SHELBYVILLE, IL 62565-1172
(217) 820-9496
Mailing address
1528 E 950 NORTH RD, LAKEWOOD, IL 62438-4029
(217) 690-8288
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
IL
Other
Enumeration date
03/17/2022
Last updated
04/06/2022
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