Provider Demographics
NPI:1275751182
Name:GRAHAM, ERIC BRIAN (DPT)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:BRIAN
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 EVERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:CRESTON
Mailing Address - State:OH
Mailing Address - Zip Code:44217-9486
Mailing Address - Country:US
Mailing Address - Phone:330-435-4565
Mailing Address - Fax:
Practice Address - Street 1:3727 FRIENDSVILLE RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-7127
Practice Address - Country:US
Practice Address - Phone:330-202-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT09339225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist