Most Relevant Information
Provider Data
| NPI Number: | 1003463035 |
| Provider Name: | DOUGLAS GRAY |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/23/2019 |
| Last Updated: | 08/23/2019 |
Provider Practice Location
7695 POE AVE
DAYTON
OH
454142552
Practice Location Phone/Fax
| Phone: | 9372802000 |
| Fax: |
Provider Mailing Location
7695 POE AVE
DAYTON
OH
454142552
Provider Mailing Phone/Fax
| Phone: | 9372802000 |
| Fax: |