Individual
MS. TANDRA RENEA GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2405 STANFORD RD APT 204, PANAMA CITY, FL 32405-3556
(850) 832-7806
Mailing address
2405 STANFORD RD APT 204, PANAMA CITY, FL 32405-3556
(850) 832-7806
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
—
Other
Enumeration date
09/14/2017
Last updated
07/21/2022
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