Individual provider · NPI-1

Riley Renay Gray

Student in an Organized Health Care Education/Training Program · Jackson, TN

NPI number1417593872
StatusActive
Last updated in NPPESNov 20, 2019

Details

NPI
1417593872
Entity type
Individual (NPI-1)
Name
Miss Riley Renay Gray
Sex
Female
Sole proprietor
No
Enumeration date
Nov 20, 2019
Last updated
Nov 20, 2019

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes
2255A2300X Specialist/Technologist, Athletic Trainer––

Practice location

1050 Union University Dr
Jackson, TN 38305-3656

Phone 731-661-6591 · Fax 731-661-5182

Mailing address

1050 Union University Dr # Uu2185
Jackson, TN 38305-3656

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