Organization
CLT CUSTOM CRANIAL PROSTHESIS
Active
Organization
CLT CUSTOM CRANIAL PROSTHESIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAULA GRAY GRAY (CEO)
(704) 996-7818
Entity
Organization
Contact information
Practice address
3709 EASTWAY DR, CHARLOTTE, NC 28205-6266
(704) 996-7818
(980) 430-3075
Mailing address
3709 EASTWAY DR, CHARLOTTE, NC 28205-6266
(704) 996-7818
(980) 430-3075
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
06/20/2026
Last updated
06/20/2026
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