Individual
JUSTIN GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
190 KIMEL PARK DR STE 139, WINSTON SALEM, NC 27103-6946
(336) 718-6931
Mailing address
2108 ENTERPRISE RD, LEXINGTON, NC 27295-7319
(336) 655-9363
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P22758
NC
Other
Enumeration date
11/13/2023
Last updated
11/13/2023
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