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Organization

PHYSICAL MEDICINE & REHABILITATION SPECIALISTS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. TODD A GRAHAM MD (OWNER)
(574) 247-4444
Entity
Organization

Contact information

Practice address
53760 GENERATIONS DR, SOUTH BEND, IN 46635-1539
(574) 247-4444
(574) 243-5555
Mailing address
53760 GENERATIONS DR, SOUTH BEND, IN 46635-1539
(574) 247-4444
(574) 243-5555

Taxonomy

Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
50003415A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200296450A
IN
Enumeration date
03/19/2007
Last updated
06/22/2010
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