Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 30689 | FL |
NPI | 1073999652 |
---|---|
Provider Name | Melia Graff |
First Address | Panama City, FL 32404-6716 |
Second Address | Panama City Beach, FL 32407-2533 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2015 |
Last Update Date | 05/08/2015 |