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1386003069
JORDAN GRAY
VALPARAISO, IN
NPI
1386003069
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: IN 06003834A)
Enumeration Date
2016-02-23
Last Update Date
2016-02-23
Business Address
JORDAN GRAY PTA
2501 CUMBERLAND DR
VALPARAISO, IN 46383-2503
Phone number: 219-462-4481
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Mailing Address
JORDAN GRAY PTA
8259 WICKER AVE
SAINT JOHN, IN 46373-8878
Phone number: 219-365-6560
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