Individual
CARLA J. GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
725 NORTH PIKE STREET, GRAFTON, WV 26354-1270
(304) 265-4909
(304) 266-4915
Mailing address
PO BOX 35, NEWBURG, WV 26410-0035
(304) 892-2828
(304) 892-2927
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
499
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810002614
—
WV
Enumeration date
09/02/2005
Last updated
02/10/2016
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