Individual
VANESSA ANNE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5453 N MITCHUM AVE, MERIDIAN, ID 83646-0004
(503) 869-6843
Mailing address
5453 N MITCHUM AVE, MERIDIAN, ID 83646-0004
(503) 869-6843
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5287
ID
Other
Enumeration date
07/08/2021
Last updated
07/08/2021
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