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Corey Kendall Graham, PT

Physical Therapist in Rogers, AR. Individual provider (NPI-1).

NPI number1124657705
StatusActive
Last updated in NPPESMay 18, 2022

Details

NPI
1124657705
Entity type
Individual (NPI-1)
Name
Corey Kendall Graham
Credential
PT
Sex
Male
Sole proprietor
No
Enumeration date
Apr 6, 2020
Certification date
May 18, 2022
Last updated
May 18, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical Therapist––Yes

Practice location

2100 W Hudson Rd
Rogers, AR 72756-2102

Phone 479-340-1100

Mailing address

2100 W Hudson Rd
Ste 3
Rogers, AR 72756-2181

Phone 407-479-2015

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