Provider Demographics
NPI:1104875608
Name:GRAF, MARIA DOLORES (DC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:DOLORES
Last Name:GRAF
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:M
Other - Middle Name:DOLORES
Other - Last Name:GRAF
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:7862 KINGLAND DR STE 201
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-2573
Mailing Address - Country:US
Mailing Address - Phone:513-755-1341
Mailing Address - Fax:513-755-5342
Practice Address - Street 1:7862 KINGLAND DR STE 201
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2573
Practice Address - Country:US
Practice Address - Phone:513-755-1341
Practice Address - Fax:513-755-5342
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1630111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0861474Medicaid
OHGR0696112Medicare ID - Type Unspecified