Individual
MS. STACY NICOLE GRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
401 LOCUST ST, SUITE 2A, CORAOPOLIS, PA 15108-3954
(412) 299-0704
(412) 299-2823
Mailing address
401 LOCUST ST, SUITE 2A, CORAOPOLIS, PA 15108-3954
(412) 299-0704
(412) 299-2823
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TEI000462
PA
Other
Enumeration date
08/07/2009
Last updated
08/07/2009
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