Provider Demographics
NPI:1770549800
Name:GRAY, DANIEL JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JOSEPH
Last Name:GRAY
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 1:130 GREATER BUTLER MART
Mailing Address - Street 2:
Mailing Address - City:BUTLER
Mailing Address - State:PA
Mailing Address - Zip Code:16001-3282
Mailing Address - Country:US
Mailing Address - Phone:724-283-8208
Mailing Address - Fax:724-283-8209
Practice Address - Street 1:130 GREATER BUTLER MART
Practice Address - Street 2:
Practice Address - City:BUTLER
Practice Address - State:PA
Practice Address - Zip Code:16001-3282
Practice Address - Country:US
Practice Address - Phone:724-283-8208
Practice Address - Fax:724-283-8209
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC-006918-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAU65446Medicare UPIN
PA894553Medicare ID - Type Unspecified