Individual
SAMUEL GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
867 LAFAYETTE RD, SEABROOK, NH 03874-4217
(603) 686-9884
Mailing address
867 LAFAYETTE RD, SEABROOK, NH 03874-4217
(603) 686-9884
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
61201861237
—
NH
Enumeration date
03/24/2019
Last updated
06/11/2019
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