Organization
GRAY CLINIC OF CHIROPRACTIC, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEVIN L GRAY D.C. (OWNER, DR.)
(217) 586-3886
Entity
Organization
Contact information
Practice address
207 E. OAK ST, MAHOMET, IL 61853
(217) 586-3886
(217) 586-4848
Mailing address
207 E. OAK ST, MAHOMET, IL 61853
(217) 586-3886
(217) 586-4848
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1015033
BLUE CROSS PIN
IL
01
—
229436
HEALTHLINK PIN
IL
Enumeration date
05/22/2007
Last updated
11/09/2007
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