Individual
MR. JACOB MICHAEL GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2 COLLEGE PARK CT, SAVOY, IL 61874-9660
(217) 493-8525
Mailing address
2017 BENTBROOK DR, CHAMPAIGN, IL 61822-9205
(217) 356-4676
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038.011216
IL
Other
Enumeration date
07/22/2008
Last updated
07/22/2008
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