Individual
KELLY GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
330 SHAMROCK RD, MANCHESTER, KY 40962-9201
(606) 598-2425
(606) 598-4448
Mailing address
PO BOX 158, MANCHESTER, KY 40962-0158
(606) 598-5564
(606) 598-6615
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
KY-2130
R.D.
KY
Enumeration date
03/15/2010
Last updated
03/15/2010
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