Gray, Jon R.

Gray, Jon R. is an sole proprietor health care provider with primary practice located at 13238 W Persimmon Ln Ste 102 , Boise ID 83713-1968. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Gray, Jon R. can be contacted via phone (208) 854-0600.

Contact Information

Primary practice address
13238 W Persimmon Ln Ste 102 Boise ID 83713-1968
Phone: (208) 854-0600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X CHIA931 Idaho

Profile Details

NPI number 1558377168
LBN Legal business name Gray, Jon R.
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 1st, 2006
Last updated May 31st, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558377168 NPPES
Idaho Other 000010029829 BLUE SHIELD PROVIDER ID
Idaho Other 1881939171 BLUE SHIELD PROVIDER ID
Idaho Other C-1849 BLUE SHIELD PROVIDER ID

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