Healthcare Provider Details

I. General information

NPI: 1407751415
Provider Name (Legal Business Name): SOLOMON GRAY
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3903 E PIMA ST
TUCSON AZ
85712-3314
US

IV. Provider business mailing address

7759 N SILVERBELL RD APT 1202
TUCSON AZ
85743-8277
US

V. Phone/Fax

Practice location:
  • Phone: 520-881-7337
  • Fax:
Mailing address:
  • Phone: 785-323-7494
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number50513
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: