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General NPI Number Information
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NPI Number | 1316265937
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Entity Type | Individual
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Provider Name | DEBRA LYNN GRAY PT, DPT, M ED
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Gender | Female
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Dates
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Enumeration Date | 05/06/2010
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Last Update Date | 05/06/2010
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Provider Practice Location Address
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Address Line | 10372 MEADOW POINTE DR
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City | JACKSONVILLE
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State | FL
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Zip | 32221-2553
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Country | US
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Telephone | 904-781-6183
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Fax | 904-827-0069
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Provider Business Mailing Address
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Address Line | 10372 MEADOW POINTE DR
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City | JACKSONVILLE
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State | FL
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Zip | 32221-2553
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Country | US
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Telephone | 904-781-6183
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Fax | 904-827-0069
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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 | PT20179
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License Number State | FL
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