Individual
NAWANA MIESA GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
OWNER/GENERAL MANAGE
Contact information
Practice address
3007 GINKGO CT, STOCKTON, CA 95212-2716
(209) 594-9951
(209) 956-0443
Mailing address
P.O. BOX 55311, STOCKTON, CA 95205-8811
(209) 594-9951
(209) 956-0443
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
11-102997
CA
Other
Enumeration date
02/26/2010
Last updated
02/26/2010
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