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Individual
JAMES WRAY
Active
Individual
JAMES WRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
40QA006934000
NJ
225100000X
Physical Therapist
Primary
34697
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
223596388
TAX IDENTIFICATION NUMBER
NJ
01
—
650022786
RR MDCR #
NJ
01
—
800062078
TAX ID
CA
Enumeration date
05/31/2005
Last updated
03/25/2010
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