Individual
HALCIAN L GRAHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
2080 W EAU GALLIE BLVD, SUITE A, MELBOURNE, FL 32935-3185
(321) 254-6218
(321) 254-6230
Mailing address
PO BOX 361907, MELBOURNE, FL 32936-1907
(321) 254-6218
(321) 254-6230
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA9103552
FL
Other
Enumeration date
11/28/2006
Last updated
02/15/2012
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