MEDICARE: EVAN WRAY DPT

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
1	225100000X	Physical Therapist	PT016518	OH

General Provider Information

NPI Number	:	1730637950
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVAN WRAY DPT

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-497-0005
Fax Number	:

Provider Business Practice Location Address
First Line	:	4501 BELMONT AVE STE 2
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44505-1042
Country	:	US
Telephone Number	:	330-576-8250
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/16/2016
Last Update Date	:	11/27/2024

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Directions to “ EVAN WRAY DPT” Practice Location

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