Individual
BRYAN JOSEPH GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BSN, RN
Contact information
Practice address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 635-5264
Mailing address
1241 W STADIUM BLVD, JEFFERSON CITY, MO 65109-6023
(573) 635-5264
Taxonomy
Speciality
Code
Description
License number
State
163WH1000X
Hospice Registered Nurse
2015024072
MO
207K00000X
Allergy & Immunology Physician
Primary
2015024072
MO
Other
Enumeration date
06/23/2022
Last updated
01/02/2025
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