Individual
JESSICA GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6279 W 88TH PL, CROWN POINT, IN 46307-9576
(219) 669-4740
Mailing address
6279 W 88TH PL, CROWN POINT, IN 46307-9576
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/06/2016
Last updated
09/06/2016
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