Provider Demographics
NPI:1528810132
Name:GRAY, ALLYSON
Entity type:Individual
Prefix:
First Name:ALLYSON
Middle Name:
Last Name:GRAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 S. WALNUT ST.
Mailing Address - Street 2:
Mailing Address - City:GNADENHUTTEN
Mailing Address - State:OH
Mailing Address - Zip Code:44629
Mailing Address - Country:US
Mailing Address - Phone:330-418-7227
Mailing Address - Fax:
Practice Address - Street 1:1460 ORANGE ST.
Practice Address - Street 2:
Practice Address - City:COSHOCTON
Practice Address - State:OH
Practice Address - Zip Code:43812
Practice Address - Country:US
Practice Address - Phone:740-623-4069
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-05
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH014866225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist