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NPI Code Detail

MEDICARE: CHARLES LESTER WRAY

MEDICARE: CHARLES LESTER WRAY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT690AR

General Provider Information

NPI Number : 1225188550
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES LESTER WRAY
Provider Business Mailing Address
First Line : 400 LINWOOD AVE
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71913-3749
Country : US
Telephone Number : 501-623-7421
Fax Number : 501-620-7847
Provider Business Practice Location Address
First Line : 400 LINWOOD AVE
Second Line :
City : HOT SPRINGS
State : AR
Zip : 71913-3749
Country : US
Telephone Number : 501-623-7421
Fax Number : 501-620-7847
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2007
Last Update Date : 07/08/2007

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Directions to “ CHARLES LESTER WRAY ” Practice Location

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