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1801203872
KELLY GRAVES
MEDFORD, NY
NPI
1801203872
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 277185-1)
Enumeration Date
2014-07-22
Last Update Date
2014-07-22
Business Address
-- KELLY GRAVES
96 JAMAICA AVE
MEDFORD, NY 11763-3518
Phone number: 631-707-6065
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Mailing Address
-- KELLY GRAVES
96 JAMAICA AVE
MEDFORD, NY 11763-3518
Phone number: 631-707-6065
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