Healthcare Provider Details

I. General information

NPI: 1821054263
Provider Name (Legal Business Name): ERIC RYAN GRAY TRATO D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

195 E HURON AVE
VASSAR MI
48768-1312
US

IV. Provider business mailing address

PO BOX 205
VASSAR MI
48768-0205
US

V. Phone/Fax

Practice location:
  • Phone: 989-823-7729
  • Fax: 989-823-1024
Mailing address:
  • Phone: 989-823-7729
  • Fax: 989-823-1024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number2301009029
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: