Provider Demographics
NPI:1780869933
Name:GRAY CHIROPRACTIC OFFICES, P.C.
Entity type:Organization
Organization Name:GRAY CHIROPRACTIC OFFICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:GRAY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:406-549-4067
Mailing Address - Street 1:3031 S RUSSELL ST
Mailing Address - Street 2:SUITE 3
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59801-8540
Mailing Address - Country:US
Mailing Address - Phone:406-549-4067
Mailing Address - Fax:406-327-6702
Practice Address - Street 1:3031 S RUSSELL ST
Practice Address - Street 2:SUITE 3
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59801-8540
Practice Address - Country:US
Practice Address - Phone:406-549-4067
Practice Address - Fax:406-327-6702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty