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Individual

LARRY E GRAHAM JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
820 CAMELOT DR, HARLINGEN, TX 78550-8400
(956) 423-2663
Mailing address
22 JEWELL GRAHAM RD, PURVIS, MS 39475-3266
(601) 550-9959

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
211236
TX
224Z00000X
Occupational Therapy Assistant
OTA12262
FL

Other

Enumeration date
06/23/2011
Last updated
02/07/2019
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