Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 2017031987 | MO |
Y | 111NR0400X | Rehabilitation Chiropractor | 3628 | MA |
NPI | 1033617105 |
---|---|
Provider Name | Dr. Sarah E Graham |
First Address | Braintree, MA 02184-5350 |
Second Address | Weymouth, MA 02188-1110 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/01/2018 |
Last Update Date | 14/09/2020 |