Individual
SPENCER GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
107 N FAYETTE AVE, MOUNT HOPE, WV 25880-1202
(304) 252-3394
Mailing address
107 N FAYETTE AVE, MOUNT HOPE, WV 25880-1202
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
07/24/2020
Last updated
06/28/2021
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