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NPI Code Detail

MEDICARE: DR. MICHAEL EDWARD GRAY D.C.

MEDICARE:  DR. MICHAEL EDWARD GRAY  D.C.
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
1111N00000XChiropractor856WV

General Provider Information

NPI Number : 1750546800
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL EDWARD GRAY D.C.
Provider Business Mailing Address
First Line : 5324 MACCORKLE AVE SE
Second Line : STE.3, C/O POZEGA WELLNESS CENTER
City : CHARLESTON
State : WV
Zip : 25304-2200
Country : US
Telephone Number : 304-993-8642
Fax Number :
Provider Business Practice Location Address
First Line : 5324 MACCORKLE AVE SE
Second Line : STE.3, C/O POZEGA WELLNESS CENTER
City : CHARLESTON
State : WV
Zip : 25304-2200
Country : US
Telephone Number : 304-993-8642
Fax Number : 304-925-7234
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2008
Last Update Date : 07/28/2008

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Directions to “ DR. MICHAEL EDWARD GRAY D.C.” Practice Location

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