Carrie Odetta Graham, MA.ATC

Individual provider Active NPI Athletic Trainer · Storrs, CT

NPI 1972533255 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1972533255
Entity type
Individual (NPI type 1)
Primary specialty
Athletic Trainer 2255A2300X
Practice address
University of Connecticut - Kinesiology
2095 Hillside Road , Unit 1110
Storrs, CT 06269-1110
Phone
(860) 486-1118
Fax
(860) 486-1123
NPI assigned
Jul 3, 2006
Sex
Female
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)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X CT Yes

Addresses

Primary practice location

University of Connecticut - Kinesiology
2095 Hillside Road , Unit 1110
Storrs, CT 06269-1110

Mailing address

University of Connecticut - Kinesiology
2095 Hillside Road , Unit 1110
Storrs, CT 06269-1110
Phone (860) 486-1118

Other providers in Storrs, CT

All providers in Storrs, CT · Athletic Trainer in Connecticut

Sources for this page

Verify at the official NPI Registry.