Individual
JENNA GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
888 TERRY PKWY, TERRYTOWN, LA 70056-5270
(504) 392-1551
Mailing address
4900 ALEXIS DR, MARRERO, LA 70072-5004
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
CPT.013954
LA
Other
Enumeration date
07/17/2017
Last updated
07/17/2017
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