Provider Demographics
NPI:1649443433
Name:GRAHAM, JUDY KAY (PT)
Entity type:Individual
Prefix:MS
First Name:JUDY
Middle Name:KAY
Last Name:GRAHAM
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7991 W 71ST AVE
Mailing Address - Street 2:
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80004-1828
Mailing Address - Country:US
Mailing Address - Phone:303-403-3115
Mailing Address - Fax:303-431-8903
Practice Address - Street 1:7991 W 71ST AVE
Practice Address - Street 2:
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80004-1828
Practice Address - Country:US
Practice Address - Phone:303-403-3115
Practice Address - Fax:303-431-8903
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2432225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist