Provider Demographics
NPI:1922437482
Name:MCCRAY, JOSHUA JR
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:MCCRAY
Suffix:JR
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 1:3819 GULLIVER ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89115-0358
Mailing Address - Country:US
Mailing Address - Phone:561-215-5314
Mailing Address - Fax:702-432-6464
Practice Address - Street 1:3819 GULLIVER ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89115-0358
Practice Address - Country:US
Practice Address - Phone:561-215-5314
Practice Address - Fax:702-432-6464
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-05
Last Update Date:2013-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner