Provider Demographics
NPI:1740412865
Name:J.M. GRAHAM & ASSOCIATES, INC.
Entity Type:Organization
Organization Name:J.M. GRAHAM & ASSOCIATES, INC.
Other - Org Name:J.M. GRAHAM & ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MW
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:
Authorized Official - Credentials:GENERAL CONTRACTOR C
Authorized Official - Phone:804-403-3855
Mailing Address - Street 1:2170 MAPLE COTTAGE LANE
Mailing Address - Street 2:
Mailing Address - City:POWHATAN
Mailing Address - State:VA
Mailing Address - Zip Code:23139-5900
Mailing Address - Country:US
Mailing Address - Phone:804-403-3855
Mailing Address - Fax:804-403-3856
Practice Address - Street 1:2170 MAPLE COTTAGE LANE
Practice Address - Street 2:
Practice Address - City:POWHATAN
Practice Address - State:VA
Practice Address - Zip Code:23139-5900
Practice Address - Country:US
Practice Address - Phone:804-403-3855
Practice Address - Fax:804-403-3856
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2705072481A171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Single Specialty