MEDICARE: JULIE ANNE GRAY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant	06003095A	IN

General Provider Information

NPI Number	:	1841454840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIE ANNE GRAY

Provider Business Mailing Address
First Line	:	404 E HIGHLAND AVE
Second Line	:
City	:	MUNCIE
State	:	IN
Zip	:	47303-3031
Country	:	US
Telephone Number	:	765-215-4544
Fax Number	:

Provider Business Practice Location Address
First Line	:	404 E HIGHLAND AVE
Second Line	:
City	:	MUNCIE
State	:	IN
Zip	:	47303-3031
Country	:	US
Telephone Number	:	765-215-4544
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2008
Last Update Date	:	07/18/2008

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