MEDICARE: MR. JOSEPH GRAY PHYSICAL THERAPIST

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	225100000X	Physical Therapist	10891	NC

General Provider Information

NPI Number	:	1972836344
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOSEPH GRAY PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	101 CAROLINE AVE
Second Line	:
City	:	WELDON
State	:	NC
Zip	:	27890-1761
Country	:	US
Telephone Number	:	252-536-4817
Fax Number	:	252-536-2137

Provider Business Practice Location Address
First Line	:	101 CAROLINE AVE
Second Line	:
City	:	WELDON
State	:	NC
Zip	:	27890-1761
Country	:	US
Telephone Number	:	252-536-4817
Fax Number	:	252-536-2137

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

Provider Enumeration Date	:	09/16/2009
Last Update Date	:	09/28/2009

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