Most Relevant Information
Provider Data
| NPI Number: | 1003567330 |
| Provider Name: | BETHANY GRAHAM |
| Entity Type: | Individual |
| Taxonomy Code: | 3747P1801X |
| Specialty: | Technician |
| License Number: |
Most Important Dates
| Enumeration Date: | 01/18/2022 |
| Last Updated: | 01/18/2022 |
Provider Practice Location
10 6TH AVE W
HUNTINGTON
WV
257010028
Practice Location Phone/Fax
| Phone: | 3045258014 |
| Fax: |
Provider Mailing Location
10 6TH AVE W
HUNTINGTON
WV
257010028
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |