Russell P Graham
Physical Therapy Assistant in North Yarmouth, ME. Individual provider (NPI-1).
NPI number1164039772
StatusActive
Last updated in NPPESSep 28, 2020
Details
- NPI
- 1164039772
- Entity type
- Individual (NPI-1)
- Name
- Russell P Graham
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Sep 28, 2020
- Certification date
- Sep 27, 2020
- Last updated
- Sep 28, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | – | – | Yes |
Practice location
1500 North RoadNorth Yarmouth, ME 04097
Phone 207-239-6625
Mailing address
1500 North RoadNorth Yarmouth, ME 04097
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