Individual
MRS. AMANDA MALONE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1325 WOLF PARK DR STE 102, GERMANTOWN, TN 38138-1759
(901) 252-3400
(901) 763-4305
Mailing address
1325 WOLF PARK DR STE 103, GERMANTOWN, TN 38138-1759
(901) 252-3400
(901) 763-4305
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2676
TN
363AS0400X
Surgical Physician Assistant
2676
TN
363AS0400X
Surgical Physician Assistant
PA00598
MS
Other
Enumeration date
11/01/2014
Last updated
09/13/2024
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