Individual
MR. BRIAN KEITH GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
2391B HIGHWAY 35, OSCEOLA, WI 54020-0129
(715) 294-1753
(715) 294-1754
Mailing address
PO BOX 129, OSCEOLA, WI 54020-0129
(715) 294-1753
(715) 294-1754
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3833
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
312T3N0
BLUE CROSS/ BLUE SHIELD
—
Enumeration date
10/17/2006
Last updated
07/08/2007
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