Clarence Edward Gray Jr.
Prosthetic/Orthotic Supplier in McDonough, GA. Individual provider (NPI-1).
NPI number1154580405
StatusActive
Last updated in NPPESJun 3, 2008
Details
- NPI
- 1154580405
- Entity type
- Individual (NPI-1)
- Name
- Mr. Clarence Edward Gray Jr.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 3, 2008
- Last updated
- Jun 3, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 335E00000X | Prosthetic/Orthotic Supplier | – | – | Yes |
Practice location
275 Courtlyn WayMcDonough, GA 30252-6997
Phone 678-234-2082
Mailing address
275 Courtlyn WayMcDonough, GA 30252-6997
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All 5 Prosthetic/Orthotic Supplier providers in McDonough · All 1,905 providers in McDonough
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