Individual
MARY NICOLE GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4645 SLIPPERY ROCK LN, COLUMBIA, VA 23038-2325
(804) 457-4153
Mailing address
4645 SLIPPERY ROCK LN, COLUMBIA, VA 23038-2325
(434) 390-9913
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
—
VA
Other
Enumeration date
02/25/2015
Last updated
07/26/2017
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