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1740707801
AUGUSTUS GRAY
PORTALES, NM
NPI
1740707801
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2017-08-29
Last Update Date
2017-08-29
Business Address
AUGUSTUS GRAY
1500 S AVE K STATION 3, SHROC
PORTALES, NM 88130
Phone number: 575-914-0123
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Mailing Address
AUGUSTUS GRAY
1500 S AVE K STATION 3, SHROC
PORTALES, NM 88130
Phone number:
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