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NPI Code Detail

MEDICARE: CHRISTINA ELAINE GRAHAM MOTR/L

MEDICARE: CHRISTINA ELAINE GRAHAM MOTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist1576WV

General Provider Information

NPI Number : 1699922682
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHRISTINA ELAINE GRAHAM MOTR/L
Provider Business Mailing Address
First Line : 775 GATEWAY DR SE APT 1107
Second Line :
City : LEESBURG
State : VA
Zip : 20175-4043
Country : US
Telephone Number : 505-553-5864
Fax Number :
Provider Business Practice Location Address
First Line : 50 MULBERRY TREE ST
Second Line :
City : CHARLES TOWN
State : WV
Zip : 25414-1274
Country : US
Telephone Number : 505-553-5864
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/21/2008
Last Update Date : 11/14/2012

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Directions to “ CHRISTINA ELAINE GRAHAM MOTR/L” Practice Location

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