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General NPI Number Information
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NPI Number | 1023658366
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Entity Type | Individual
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Provider Name | KATHARINE LEA GRAY DPT
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Gender | Female
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Dates
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Enumeration Date | 01/15/2020
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Last Update Date | 01/15/2020
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Provider Practice Location Address
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Address Line | 9600 PATTERSON AVE
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City | RICHMOND
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State | VA
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Zip | 23229-6053
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Country | US
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Telephone | 804-285-6818
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Fax | 804-754-4292
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Provider Business Mailing Address
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Address Line | 807 FARNWOOD DR
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City | HENRICO
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State | VA
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Zip | 23229-6317
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Country | US
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Telephone | 804-370-8448
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 2305210464
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License Number State | VA
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