Provider Demographics
NPI:1689177750
Name:GRAY, SKYLER JAMES (DC)
Entity Type:Individual
Prefix:
First Name:SKYLER
Middle Name:JAMES
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 1:131 CRANMOOR DR
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08753-6805
Mailing Address - Country:US
Mailing Address - Phone:732-575-2069
Mailing Address - Fax:
Practice Address - Street 1:683 BAY AVE
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-3407
Practice Address - Country:US
Practice Address - Phone:732-244-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-14
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00136400171100000X
NJ38MC00751200111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No171100000XOther Service ProvidersAcupuncturist