Jessica Gray, PTA

NPI #1093087868 in Fond Du Lac, Wisconsin

Provider Information

NPI Number: 1093087868
Entity Type: Individual
Name: Jessica Gray, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Feb 8, 2012
Last Updated: Feb 8, 2012

Practice Location

Address: 103 S PIONEER RD
Address 2: SUITE #100
City: Fond Du Lac
State: Wisconsin
ZIP Code: 54935-3800
Phone: (920) 922-7776

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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