Provider Demographics
NPI:1700615986
Name:PIKE, GRAYSON DANIEL
Entity type:Individual
Prefix:
First Name:GRAYSON
Middle Name:DANIEL
Last Name:PIKE
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 1:1761 MARROSE DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-1551
Mailing Address - Country:US
Mailing Address - Phone:740-777-0160
Mailing Address - Fax:
Practice Address - Street 1:1761 MARROSE DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-1551
Practice Address - Country:US
Practice Address - Phone:740-777-0160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide