Individual
BRADLEY THOMAS GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
11114 ALMOND DR, GREY EAGLE, MN 56336-4643
(605) 413-7349
Mailing address
PO BOX 156, GREY EAGLE, MN 56336-0156
(507) 475-4354
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2493855
MN
164W00000X
Licensed Practical Nurse
763648
MN
Other
Enumeration date
06/06/2021
Last updated
04/26/2022
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