Individual
MR. HENRY PAUL GRAYNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
100 LOCK ST, NEWARK, NJ 07102
(973) 596-5242
Mailing address
100 LOCK ST, NEWARK, NJ 07102
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
25MT00023800
NJ
Other
Enumeration date
11/14/2018
Last updated
11/14/2018
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