Provider Demographics
NPI:1346264397
Name:GRAY, JAMES C (DC)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:C
Last Name:GRAY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1033 E TURKEYFOOT LAKE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312-7200
Mailing Address - Country:US
Mailing Address - Phone:330-896-9000
Mailing Address - Fax:330-896-9002
Practice Address - Street 1:1033 E TURKEYFOOT LAKE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312-7200
Practice Address - Country:US
Practice Address - Phone:330-896-9000
Practice Address - Fax:330-896-9002
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2537111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2045138Medicaid
OH2045138Medicaid
OHGR0881251Medicare ID - Type Unspecified