Most Relevant Information
Provider Data
| NPI Number: | 1003012675 |
| Provider Name: | MICHELLE IRENE GRAY |
| Entity Type: | Individual |
| Taxonomy Code: | 225400000X |
| Specialty: | Rehabilitation Practitioner |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/21/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
2450 RIVERSIDE AVE
MINNEAPOLIS
MN
554541450
Practice Location Phone/Fax
| Phone: | 6126726000 |
| Fax: |
Provider Mailing Location
1920 FOUNTAIN LN
WACONIA
MN
553874600
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |