NPI 1023316932
Jason Michael Graham, ATCLAT
Practice location
- Address
- 12499 University Ave STE 210, Clive, IA 50325-8288
- Phone
- (515) 240-2676
- Mailing address
- 5724 Clark Blvd, Des Moines, IA 50311-2052
Registered specialties
Athletic Trainer
Primary
Registry record
- NPI
- 1023316932
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 2 Mar 2011
- Record last updated
- 2 Jun 2021
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.