| Doctor Name: | MS. CARISSE CHRISTINE GRAHAM |
| NPI Number: | 1356453146 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | P.T. |
| License Number: | PT10024 |
| Business Practice Address: | 11595 East Lakewood Boulevard Suite 80 Holland, MI - 49424 |
| Business Phone Number: | 6165942000 |
| Business Fax Number: | 6165942004 |
| Mailing Address: | 11595 East Lakewood Boulevard, Suite 80 HOLLAND |
| State: | MI |
| Postal Code: | 49424 |
| Phone Number: | 6165942000 |
| Fax Number: | 6165942004 |
| NPI Enumeration Date: | 08/31/2006 |
| NPI Last Update Date: | 02/15/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT10024 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | WA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |