Russell P Graham
Individual provider Active NPI Physical Therapy Assistant · North Yarmouth, ME
NPI 1164039772 · NPPES record last updated Sep 28, 2020
Key facts
- NPI
- 1164039772
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- Practice address
- 1500 North Road
North Yarmouth, ME 04097 - Phone
- (207) 239-6625
- NPI assigned
- Sep 28, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | Yes |
Addresses
Primary practice location
1500 North Road
North Yarmouth, ME 04097
Mailing address
1500 North Road
North Yarmouth, ME 04097
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| HP5800824-02 | Other | PERSONAL INSURANCE |
Other providers in North Yarmouth, ME
- Kristy Del Coro
- Griffin R Devine
- Joseph Richard Fitzpatrick
- Nicole Elizabeth Glidden
- Lisa Nada Glines
- S Kimble Greene
- Hosanah Care
- Emily Lou Isom
- Sharon Lee Kuhrt
- Zoe Laferriere
All providers in North Yarmouth, ME · Physical Therapy Assistant in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 28, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.