Individual
SHANNON GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
605 N GILBERT RD, MESA, AZ 85203-6629
(480) 398-1220
(480) 398-1238
Mailing address
605 N GILBERT RD, MESA, AZ 85203-6629
(480) 398-1220
(480) 398-1238
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Enumeration date
12/29/2017
Last updated
12/29/2017
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