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Individual

MR. JAY PATRICK GRAYSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CSFA, SA-C

Contact information

Practice address
114 E MCGUIRE ST, BELL BUCKLE, TN 37020-6052
(931) 205-2753
Mailing address
PO BOX 802, LYNCHBURG, TN 37352-0802
(931) 205-2753

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
103596
TN
246ZC0007X
Surgical Assistant
Primary
13-456
TN

Other

Enumeration date
08/28/2016
Last updated
08/28/2016
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