Provider Demographics
NPI:1154554285
Name:GRAY, JOSEPH HUNTER (PT, DPT)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:HUNTER
Last Name:GRAY
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 HUNTER ST
Mailing Address - Street 2:
Mailing Address - City:SCHRIEVER
Mailing Address - State:LA
Mailing Address - Zip Code:70395-3420
Mailing Address - Country:US
Mailing Address - Phone:985-872-5911
Mailing Address - Fax:985-872-6155
Practice Address - Street 1:478 CORPORATE DR
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-2461
Practice Address - Country:US
Practice Address - Phone:985-872-5911
Practice Address - Fax:985-872-6155
Is Sole Proprietor?:No
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07640225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist