Individual
NICOLE LYNN GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
413 NW 3RD ST, 413 NW 3RD ST, PRINEVILLE, OR 97754
(541) 291-3488
Mailing address
413 NW 3RD ST, 413 NW 3RD STREET, PRINEVILLE, OR 97754
(541) 291-3488
Taxonomy
Speciality
Code
Description
License number
State
156F00000X
Technician/Technologist
Primary
NT-10189794
OR
Other
Enumeration date
10/25/2024
Last updated
10/25/2024
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