Provider Demographics
NPI:1356599120
Name:GRAHAM, TARSHA-ANN (DPT)
Entity type:Individual
Prefix:
First Name:TARSHA-ANN
Middle Name:
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1512 TARRINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-4358
Mailing Address - Country:US
Mailing Address - Phone:347-414-3701
Mailing Address - Fax:
Practice Address - Street 1:1512 TARRINGTON WAY
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-4358
Practice Address - Country:US
Practice Address - Phone:347-414-3701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-04
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0293701225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist