Individual
DIANE MARIE GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2005 ASHLAND AVE, TOLEDO, OH 43620-1703
(419) 841-7701
Mailing address
2005 ASHLAND AVE, TOLEDO, OH 43620-1703
(419) 841-7701
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
104012.MEDS
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164W00000X
—
OH
Enumeration date
11/21/2018
Last updated
11/21/2018
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