Provider Demographics
NPI:1417250465
Name:LERAY, FRANK ALAN JR (DC)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:ALAN
Last Name:LERAY
Suffix:JR
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 1:1375 S 16TH ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-6421
Mailing Address - Country:US
Mailing Address - Phone:910-343-1212
Mailing Address - Fax:910-343-1178
Practice Address - Street 1:1375 S 16TH ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-6421
Practice Address - Country:US
Practice Address - Phone:910-343-1212
Practice Address - Fax:910-343-1178
Is Sole Proprietor?:No
Enumeration Date:2010-12-14
Last Update Date:2012-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4300111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor