Provider Demographics
NPI:1891032884
Name:PRAY, GREGORY D (DC)
Entity Type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:D
Last Name:PRAY
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 1:2765 86TH ST
Mailing Address - Street 2:
Mailing Address - City:URBANDALE
Mailing Address - State:IA
Mailing Address - Zip Code:50322-4336
Mailing Address - Country:US
Mailing Address - Phone:515-344-1143
Mailing Address - Fax:
Practice Address - Street 1:2765 86TH ST
Practice Address - Street 2:
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322-4336
Practice Address - Country:US
Practice Address - Phone:515-344-1143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-10
Last Update Date:2020-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007604111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA3UOLAGJPGMedicaid
IAIB2699Medicare UPIN