National Provider Identifier
Graham R Widrick, PT
Graham R Widrick, PT is listed in the NPPES registry with a primary specialty of Physical Therapist in Fairport, NY and a listed phone number of (585) 880-9553.
Profile Overview
- NPI
- 1821079427
- Provider Type
- Individual
- Primary Specialty
- Physical Therapist
- Enumeration Date
- November 10, 2005
- Last Updated
- September 17, 2009
Practice Location
- 44 Gentian Way
- Fairport, NY 14450-9212
Phone: (585) 880-9553
Specialties
- Physical Therapist (225100000X)
Full Record
- NPI
- 1821079427
- Entity Type
- Individual
- Last Name
- Widrick
- First Name
- Graham
- Middle Name
- R
- Name Prefix
- Mr.
- Credential
- PT
- Mailing Street Address
- 44 Gentian Way
- Mailing City
- Fairport
- Mailing State
- NY
- Mailing ZIP Code
- 14450-9212
- Mailing Country
- US
- Practice Street Address
- 44 Gentian Way
- Practice City
- Fairport
- Practice State
- NY
- Practice ZIP Code
- 14450-9212
- Practice Country
- US
- Practice Phone
- (585) 880-9553
- Enumeration Date
- November 10, 2005
- Last Updated
- September 17, 2009
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Therapist (225100000X)
- Other Identifiers
- C775Q (NC, BCBS), 5142742 (NC, Aetna)