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1780220046
KELLY GRAYSON
FORT WAYNE, IN
NPI
1780220046
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date
2019-11-21
Last Update Date
2019-11-21
Business Address
KELLY GRAYSON
1300 E WASHINGTON CENTER RD
FORT WAYNE, IN 46825-4556
Phone number: 260-496-4700
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Mailing Address
KELLY GRAYSON
1935 BEAR PAW DR
FORT WAYNE, IN 46815-7925
Phone number: 260-271-3693
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