Provider Demographics
NPI:1396359964
Name:GRAHAM, CHRISTOPHER SCOTT (LMT)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:SCOTT
Last Name:GRAHAM
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6422 AIRPORT BLVD
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-3702
Mailing Address - Country:US
Mailing Address - Phone:423-883-1433
Mailing Address - Fax:
Practice Address - Street 1:6422 AIRPORT BLVD
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3702
Practice Address - Country:US
Practice Address - Phone:423-883-1433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-01
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist