Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 007083 | KY |
NPI | 1962983809 |
---|---|
Provider Name | Mrs. Katherine Leigh Graham |
First Address | Fort Thomas, KY 41075-2300 |
Second Address | Fort Thomas, KY 41075-2300 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/08/2018 |
Last Update Date | 28/08/2018 |