Individual
MARY GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 CURVE CREST BLVD W, STILLWATER, MN 55082
(651) 439-1234
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
(651) 439-1234
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
6247
MN
Other
Enumeration date
01/18/2016
Last updated
09/12/2018
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