| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JEREMY ROY GRAY | 1275149767 | 2020-09-20 |
Jeremy Roy Gray is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1275149767. Registration indicates Jeremy Roy Gray is a provider of services with a specialization in Dietary & Nutritional Service Providers, Dietitian, Registered (Dietitian, Registered, ) (All Other Specialties & Provider Types, ) (Dietitian, Registered, Dietary & Nutritional Service Providers)
| Entity Type | Individual |
| Provider Name | Jeremy Roy Gray |
| Practice Office Address | 1409 BALLENTINE DAIRY RD FUQUAY VARINA, NC US |
| Practice Office Telephone | 9197401134 |
| Mailing Address | 1409 BALLENTINE DAIRY RD FUQUAY VARINA, NC 275268323 US |
| Business Telephone | 9197401134 |
| Code | Practice | License No State |
|---|---|---|
| 133V00000X PRIMARY | Dietary & Nutritional Service Providers Dietitian, Registered Dietitian, Registered All Other Specialties & Provider Types Dietitian, Registered Dietary & Nutritional Service Providers | 86289495
NC |