Healthcare Provider Details

I. General information

NPI: 1174462139
Provider Name (Legal Business Name): CONNOR VALERIO MCGRAW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 EXTON CMNS
EXTON PA
19341-2449
US

IV. Provider business mailing address

1836 UNIONVILLE RD
POTTSTOWN PA
19465-7109
US

V. Phone/Fax

Practice location:
  • Phone: 484-945-3066
  • Fax:
Mailing address:
  • Phone: 484-945-3066
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMSG016625
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: