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Contact Information

MARY F GRAHAM, PTA
1901 N. 13TH STREET
HERRIN, IL62948
 Phone: 618-942-3274
 Fax: 618-942-8240
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapy Assistant

225200000X
Indicates primary specialty

NPI Profile & details for MARY F GRAHAM · (Female)

NPI # 1174771422
Status Active
Credentials PTA (Physical Therapist Assistant)
Entity Individual
Enumeration date 08/28/2008
Last updated 08/28/2008 - About 18 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 160002054
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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