Individual
JOHNATHAN GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5834 TWILIGHT AVE, FIRESTONE, CO 80504-6486
(303) 775-7794
Mailing address
5834 TWILIGHT AVE, FIRESTONE, CO 80504-6486
(303) 775-7794
Taxonomy
Speciality
Code
Description
License number
State
2471C3402X
Radiography Radiologic Technologist
Primary
525624
CO
Other
Enumeration date
07/21/2014
Last updated
07/21/2014
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