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General NPI Number Information
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NPI Number | 1881922730
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Entity Type | Individual
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Provider Name | CARRIE J GRAVES DOM, AP
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Gender | Female
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Dates
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Enumeration Date | 12/03/2009
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Last Update Date | 08/19/2013
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Provider Practice Location Address
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Address Line | 28467 US HIGHWAY 19 N SUITE 302
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City | CLEARWATER
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State | FL
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Zip | 33761-4333
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Country | US
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Telephone | 727-216-6929
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Fax |
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Provider Business Mailing Address
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Address Line | 28467 US HIGHWAY 19 N SUITE 302
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City | CLEARWATER
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State | FL
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Zip | 33761-4333
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Country | US
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Telephone | 727-216-6929
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number |
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC01241
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License Number State | TX
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