Provider Demographics
NPI:1326914540
Name:GRAY, DAVID GRAY
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:GRAY
Last Name:GRAY
Suffix:
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 1:299 TAMBRAS WAY
Mailing Address - Street 2:
Mailing Address - City:VILAS
Mailing Address - State:NC
Mailing Address - Zip Code:28692-6011
Mailing Address - Country:US
Mailing Address - Phone:828-260-2444
Mailing Address - Fax:
Practice Address - Street 1:379 NEW MARKET BLVD
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-3765
Practice Address - Country:US
Practice Address - Phone:828-260-2444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-14
Last Update Date:2025-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20119225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist