Tracie Renee Graham O.T.

NPI 1265550875 - Specialist - 174400000X

NPI Details
NPI 1265550875
Gender Female
Enumeration Date 03/26/2007
Last Updated 07/09/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
413 W. TYLER COVE
WEST MEMPHIS AR, 72301, US
Phone (870) 733-1200
Fax (870) 732-3269
Business Location
4734 BETHAY DR
MEMPHIS TN, 38125-5700, US
Phone (901) 494-3710
Fax (870) 733-1200
Toxanomy
Taxonomy Code 174400000X
License State Arkansas
License Number OTR1280
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According to our database, Mrs. Tracie Renee Graham O.T. NPI is 1265550875, taxonomy code is 174400000X and license number is OTR1280, license state is located at Arkansas. Tracie Renee Graham O.T. physically located at 413 W. Tyler Cove, West Memphis AR, 72301. NPI Number Tracie Renee Graham O.T. has the Individual type.

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1265550875 NPI number is provided on an as is basis without warranty of any kind. 1265550875 is maintained by the National Plan & Provider Enumeration System. The contents of Tracie Renee Graham O.T. are for informational purposes only.