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General NPI Number Information
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NPI Number | 1356453146
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Entity Type | Individual
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Provider Name | CARISSE CHRISTINE GRAHAM P.T.
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Gender | Female
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 1665 HAMILTON RD STE 100
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City | OKEMOS
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State | MI
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Zip | 48864-1809
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Country | US
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Telephone | 517-349-1110
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Fax | 517-349-6892
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Provider Business Mailing Address
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Address Line | 1665 HAMILTON RD STE 100
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City | OKEMOS
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State | MI
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Zip | 48864-1809
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Country | US
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Telephone | 517-349-1110
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Fax | 517-349-6892
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PTL.0016875
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1252818
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501016147
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License Number State | MI
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