Individual
MRS. DEANNA GAIL GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
80 MADDEX DR, SHEPHERDSTOWN, WV 25443-4305
(304) 876-9422
Mailing address
245 AUSTIN DR, MARTINSBURG, WV 25403-0267
(443) 257-4088
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
001789
WV
Other
Enumeration date
10/24/2012
Last updated
10/24/2012
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