MEDICARE: NEEVE JESSE GRAHAM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	P25002	NC

General Provider Information

NPI Number	:	1750216784
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NEEVE JESSE GRAHAM

Provider Business Mailing Address
First Line	:	730 HAWTHORNE LN APT 267
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28204-2177
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	211 W MATTHEWS ST
Second Line	:
City	:	MATTHEWS
State	:	NC
Zip	:	28105-1309
Country	:	US
Telephone Number	:	704-846-0262
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/12/2026
Last Update Date	:	06/12/2026

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Directions to “ NEEVE JESSE GRAHAM ” Practice Location

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