| NPI | 1609065416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY R GRAY Owner 307-856-4945 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: WY 513) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: WY WY513) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2017-10-13 |