Individual
KATHRYN GRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
800 E ATWATER AVE, BLOOMINGTON, IN 47405-3635
(812) 855-4447
Mailing address
800 E ATWATER AVE, BLOOMINGTON, IN 47405-3635
(812) 855-4447
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18003356A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200523020
—
IN
Enumeration date
03/10/2006
Last updated
09/29/2008
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