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Individual

MR. STANLEY K GRAY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
B.A.

Contact information

Practice address
5100 2ND ST NW, ALBUQUERQUE, NM 87107-4009
(505) 239-6438
(505) 342-3785
Mailing address
PO BOX 6506, ALBUQUERQUE, NM 87197-6506
(505) 239-6438
(505) 342-3785

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NM600050
VALUE OPTIONS
NM
Enumeration date
12/19/2006
Last updated
07/08/2007
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