Individual
KATHLEEN GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
109 WYANDOT ST, DARLINGTON, SC 29532-4210
(843) 393-7833
Mailing address
109 WYANDOT ST, DARLINGTON, SC 29532-4210
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R19058
SC
Other
Enumeration date
04/09/2014
Last updated
04/09/2014
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