Provider Demographics
NPI:1750681615
Name:WRAY, LEE V (RPH)
Entity Type:Individual
Prefix:MR
First Name:LEE
Middle Name:V
Last Name:WRAY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5554 SAWDUST LOOP
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80134-4564
Mailing Address - Country:US
Mailing Address - Phone:678-472-0990
Mailing Address - Fax:
Practice Address - Street 1:5554 SAWDUST LOOP
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134-4564
Practice Address - Country:US
Practice Address - Phone:678-472-0990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO016523183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist