Individual
DR. JORDAN BRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC, ND
Contact information
Practice address
110 S STANFIELD RD, SUITE A, TROY, OH 45373-3098
(937) 418-2822
Mailing address
9940 N HETZLER RD, PIQUA, OH 45356-9556
(937) 418-8007
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038.012707
IL
111N00000X
Chiropractor
Primary
4559
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
47-5275818
FEDERAL TAX ID
OH
Enumeration date
11/06/2015
Last updated
11/06/2015
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