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General NPI Number Information
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NPI Number | 1912293994
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Entity Type | Organization
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Legal Business Name | GRAHAM CHIROPRACTIC & HEALTH
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Dates
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Enumeration Date | 06/28/2011
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Last Update Date | 06/28/2011
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Provider Practice Location Address
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Address Line | 5851 RAMSEY ST
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City | FAYETTEVILLE
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State | NC
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Zip | 28311-3475
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Country | US
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Telephone | 910-823-4879
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Fax |
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Provider Business Mailing Address
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Address Line | 5851 RAMSEY ST
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City | FAYETTEVILLE
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State | NC
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Zip | 28311-3475
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Country | US
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Telephone | 910-823-4879
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINIC DIRECTOR
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Name | STEPHANYE GRAHAM
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Credential | D.C.
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Telephone | 910-823-4879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 4038
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License Number State | NC
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