Provider Demographics
NPI:1891958062
Name:GRAY, AARON MARC II (DC)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:MARC
Last Name:GRAY
Suffix:II
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6405 TELEGRAPH RD
Mailing Address - Street 2:SUITE D-2
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48301-1716
Mailing Address - Country:US
Mailing Address - Phone:248-647-3336
Mailing Address - Fax:248-647-4899
Practice Address - Street 1:6405 TELEGRAPH RD
Practice Address - Street 2:SUITE D-2
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48301-1716
Practice Address - Country:US
Practice Address - Phone:248-647-3336
Practice Address - Fax:248-647-4899
Is Sole Proprietor?:No
Enumeration Date:2008-07-08
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301009481111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI95-0-F3-6299-0OtherBLUE CROSS BLUE SHEILD OF MICHIGAN