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General NPI Number Information
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NPI Number | 1821047903
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Entity Type | Individual
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Provider Name | GRAHAM C GANDEE
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Gender | Male
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Dates
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Enumeration Date | 05/08/2006
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Last Update Date | 08/14/2012
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Provider Practice Location Address
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Address Line | 370 HIGHLAND PARK DR SUITE 1
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City | RICHMOND
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State | KY
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Zip | 40475-3546
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Country | US
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Telephone | 859-623-4567
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Fax | 888-474-7740
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Provider Business Mailing Address
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Address Line | 370 HIGHLAND PARK DR SUITE 1
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City | RICHMOND
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State | KY
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Zip | 40475-3546
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Country | US
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Telephone | 859-623-4567
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Fax | 888-474-7740
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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 | 004333
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License Number State | KY
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