Provider Demographics
NPI:1275767477
Name:GRAHAM, VELMA CHRISTINE (MASSAGE THERAPIST)
Entity Type:Individual
Prefix:MS
First Name:VELMA
Middle Name:CHRISTINE
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:MASSAGE THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:COPPERAS COVE
Mailing Address - State:TX
Mailing Address - Zip Code:76522-2903
Mailing Address - Country:US
Mailing Address - Phone:254-394-1140
Mailing Address - Fax:
Practice Address - Street 1:704 S 2ND ST
Practice Address - Street 2:
Practice Address - City:COPPERAS COVE
Practice Address - State:TX
Practice Address - Zip Code:76522-2903
Practice Address - Country:US
Practice Address - Phone:254-394-1140
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-04
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMT024854225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist