Individual
PRESTON GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2230 NORTH UNIVERSITY PARKWAY #1A, PROVO, UT 84604
(801) 377-3413
Mailing address
2230 NORTH UNIVERSITY PARKWAY #1A, PROVO, UT 84604
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8501262-1206
UT
Other
Enumeration date
12/14/2012
Last updated
12/14/2012
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