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General NPI Number Information
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NPI Number | 1609158351
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Entity Type | Organization
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Legal Business Name | GRAHAM FITNESS AND WELLNESS CENTER
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Dates
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Enumeration Date | 09/19/2011
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Last Update Date | 09/19/2011
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Provider Practice Location Address
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Address Line | 815 MONTGOMERY RD
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City | GRAHAM
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State | TX
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Zip | 76450-4241
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Country | US
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Telephone | 940-521-5325
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Fax | 940-521-5151
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Provider Business Mailing Address
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Address Line | 815 MONTGOMERY RD
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City | GRAHAM
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State | TX
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Zip | 76450-4241
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Country | US
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Telephone | 940-521-5325
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Fax | 940-521-5151
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Authorized Official
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Title or Position | SPEECH LANGUAGE PATHOLOGIST
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Name | BETHANY LANKFORD
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Credential | M.S. CCC-SLP
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Telephone | 940-521-5325
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 103560
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License Number State | TX
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