Individual
LISA ELIZABETH GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4218 BURTON ST SE, GRAND RAPIDS, MI 49546-6121
(616) 301-8000
Mailing address
4218 BURTON ST SE, GRAND RAPIDS, MI 49546-6121
(616) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Enumeration date
09/02/2025
Last updated
09/02/2025
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