Individual
TAMMY LYNN GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
1401 10TH ST, ALAMOGORDO, NM 88310-5012
(575) 437-3351
Mailing address
PO BOX 2860, ALAMOGORDO, NM 88311-2860
(575) 437-3351
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
2333
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
326563
MEDICARE
NM
05
—
65608739
—
NM
Enumeration date
04/02/2009
Last updated
04/02/2009
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