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General NPI Number Information
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NPI Number | 1003969924
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Entity Type | Organization
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Legal Business Name | GRAY CHIROPRACTIC PLLC
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 10/30/2007
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Provider Practice Location Address
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Address Line | 229 DEAHL ST
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City | BORGER
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State | TX
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Zip | 79007-4707
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Country | US
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Telephone | 806-273-3366
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Fax | 806-273-2532
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Provider Business Mailing Address
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Address Line | PO BOX 1127
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City | BORGER
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State | TX
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Zip | 79008-1127
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Country | US
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Telephone | 806-273-3366
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Fax | 806-273-2532
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Authorized Official
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Title or Position | MANAGER
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Name | DR. KENT D. GRAY
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Credential | D.C.
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Telephone | 806-273-3366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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