Provider Demographics
NPI:1972736585
Name:MC CRAY, WYOMA G (PT)
Entity type:Individual
Prefix:
First Name:WYOMA
Middle Name:G
Last Name:MC CRAY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 PITZERS CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25403-6003
Mailing Address - Country:US
Mailing Address - Phone:304-676-6746
Mailing Address - Fax:304-263-9409
Practice Address - Street 1:18 PITZERS CHAPEL RD
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25403-6003
Practice Address - Country:US
Practice Address - Phone:304-676-6746
Practice Address - Fax:304-263-9409
Is Sole Proprietor?:No
Enumeration Date:2009-08-30
Last Update Date:2009-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV000954225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist