Individual
MR. JEREMY RAY GREGORY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT
Contact information
Practice address
405 S BROAD ST, CHANDLER, TX 75758
(214) 802-2340
Mailing address
405 S BROAD ST, CHANDLER, TX 75758
(214) 802-2340
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT3865
TX
Other
Enumeration date
08/06/2007
Last updated
08/06/2007
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