Provider Demographics
NPI:1598361156
Name:DRAY, LARRY
Entity Type:Individual
Prefix:
First Name:LARRY
Middle Name:
Last Name:DRAY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2780 N REVERE RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44333-1230
Mailing Address - Country:US
Mailing Address - Phone:330-523-9734
Mailing Address - Fax:
Practice Address - Street 1:2780 N REVERE RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-1230
Practice Address - Country:US
Practice Address - Phone:330-523-9734
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-09
Last Update Date:2020-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide