Individual
CRYSTAL J GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3427 W VILLARD AVE, APT 307, MILWAUKEE, WI 53209-4700
(414) 388-5340
Mailing address
3427 W VILLARD AVE, APT 307, MILWAUKEE, WI 53209-4700
(414) 388-5340
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
32603-031
WI
Other
Enumeration date
04/03/2014
Last updated
04/03/2014
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