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General NPI Number Information
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NPI Number | 1720496458
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Entity Type | Individual
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Provider Name | MICHAEL MCGRAW DPT
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Gender | Male
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Dates
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Enumeration Date | 07/25/2014
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Last Update Date | 03/15/2022
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Provider Practice Location Address
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Address Line | 214 6TH ST STE A
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City | HONESDALE
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State | PA
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Zip | 18431-1801
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Country | US
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Telephone | 570-228-2142
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Fax | 570-228-2349
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Provider Business Mailing Address
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Address Line | 208 S MAIN ST
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City | MOSCOW
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State | PA
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Zip | 18444-9135
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Country | US
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Telephone | 570-842-9323
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | TPT021560
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License Number State | PA
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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 | PT023691
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License Number State | PA
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