Individual
LISA KAREN GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
600 WAVERLY AVE UNIT 2, PATCHOGUE, NY 11772-1529
(631) 559-3126
Mailing address
8 2ND ST, FARMINGVILLE, NY 11738-2304
(631) 559-3126
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
022244
NY
Other
Enumeration date
09/27/2021
Last updated
09/27/2021
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