Individual
MR. TYLER ANDREW GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
445 COMMONWEALTH BLVD E, MARTINSVILLE, VA 24112-2086
(276) 634-5690
Mailing address
280 BOOTH RD, HARDY, VA 24101-5104
(540) 314-1689
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
CPO04879
VA
224P00000X
Prosthetist
CPO04879
VA
Other
Enumeration date
12/11/2023
Last updated
12/11/2023
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