Individual
AMANDA GRAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
401 BURRO ALY, MORENCI, AZ 85540-9647
(928) 865-9184
(928) 865-7571
Mailing address
401 BURRO ALY, PO BOX 218, MORENCI, AZ 85540-9647
(928) 865-9184
(928) 865-7571
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA2009-0040
NM
363A00000X
Physician Assistant
PA9104721
FL
363AM0700X
Medical Physician Assistant
Primary
5389
AZ
Other
Enumeration date
10/03/2008
Last updated
06/05/2013
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