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Individual

MR. CHARLES M GRAY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
5863 RENNINGER ROAD, NEW FRANKLIN, OH 44319
(330) 212-8757
Mailing address
5863 RENNINGER RD, NEW FRANKLIN, OH 44319
(330) 212-8757

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
OH
3747P1801X
Personal Care Attendant
Primary
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
7716529
OH
Enumeration date
10/22/2020
Last updated
10/22/2020
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