Individual
PAUL CANNIFF GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
219 BERRY RIDGE LN, SUFFOLK, VA 23435-3190
(757) 338-0353
Mailing address
219 BERRY RIDGE LN, SUFFOLK, VA 23435-3190
(757) 338-0353
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
T60621503
VA
Other
Enumeration date
03/23/2020
Last updated
03/23/2020
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