MRS. Rita Rae Graham, NCTMB

NPI #1003149766 in Libertyville, Illinois

Provider Information

NPI Number: 1003149766
Entity Type: Individual
Name: MRS. Rita Rae Graham, NCTMB
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Credential: NCTMB
Enumeration Date: Sep 14, 2009
Last Updated: Sep 14, 2009

Practice Location

Address: 1244 AMERICAN WAY
City: Libertyville
State: Illinois
ZIP Code: 60048-3936
Phone: (847) 549-9595

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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