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Individual

DR. JOHN GRAHAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
21 EXECUTIVE PARK DR, CLIFTON PARK, NY 12065-8651
(518) 371-5422
(518) 371-2063
Mailing address
21 EXECUTIVE PARK DR, CLIFTON PARK, NY 12065-8651
(518) 371-5422
(518) 371-2063

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X2183
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10035363
CDPHP
NY
01
98L1853
MVP
NY
01
C02183-4
WORKER COMPENSATION
NY
01
X3A141
EMPIRE BC/BS
NY
Enumeration date
08/28/2006
Last updated
04/30/2008
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