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NPI Code Detail

MEDICARE: GRAY CHIROPRACTIC PC

MEDICARE: GRAY CHIROPRACTIC PC
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
1111N00000XChiropractorDC19806CA

General Provider Information

NPI Number : 1770740607
Entity Type Code : Organization
Provider Name (Legal Business Name) : GRAY CHIROPRACTIC PC
Provider Business Mailing Address
First Line : 414 9TH ST
Second Line :
City : CRESCENT CITY
State : CA
Zip : 95531-3430
Country : US
Telephone Number : 707-465-4729
Fax Number :
Provider Business Practice Location Address
First Line : 414 9TH ST
Second Line :
City : CRESCENT CITY
State : CA
Zip : 95531-3430
Country : US
Telephone Number : 707-465-4729
Fax Number :
Authorized Official
Title or Position : OWNER
Name : DR. SEAN GRAY
Credential : D.C.
Telephone Number : 707-465-4729
Provider Enumeration Date : 05/19/2008
Last Update Date : 05/19/2008

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Directions to “GRAY CHIROPRACTIC PC ” Practice Location

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