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Individual

JIMMY LEE GRAHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
13901 SE 71ST PLACE, OKLAHOMA CITY, OK 73115
(405) 386-4623
Mailing address
13901 SE 71ST PLACE, OKLAHOMA CITY, OK 73115
(405) 386-4623

Taxonomy

Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary

Other

Enumeration date
10/20/2006
Last updated
07/08/2007
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