Individual
GREGORY RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2500 MT MORIAH RD, MEMPHIS, TN 38115
(901) 240-0427
Mailing address
PO BOX 163, MEMPHIS, TN 38101-0163
(901) 240-0427
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
504631134
TN
Other
Enumeration date
09/18/2012
Last updated
09/18/2012
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