Individual
MRS. POLLY RAE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBA, RD, LD
Contact information
Practice address
1227 E RUSHOLME ST, DAVENPORT, IA 52803-2459
(563) 421-6943
(563) 421-6959
Mailing address
6395 115TH ST, BLUE GRASS, IA 52726-9609
(563) 381-4113
(563) 421-1714
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
00732
IA
Other
Enumeration date
05/15/2007
Last updated
07/08/2007
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