Individual
RYAN FARRELL GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
A3669 BUTNER RD, FORT BRAGG, NC 28310-0001
(910) 850-1619
Mailing address
530 VIC KEITH RD, SANFORD, NC 27332-1152
(910) 850-1619
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT2652
SC
Other
Enumeration date
04/08/2022
Last updated
09/27/2022
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