Mary E Wray, LMT, NMT
Individual provider Active NPI Naturopath · Palm Coast, FL
NPI 1104940980 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1104940980
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Naturopath 175F00000X
- License
- MA27453 (FL)
- Practice address
- 21 Old Kings Rd N Ste 215
Palm Coast, FL 32137-8254 - Phone
- (386) 212-6068
- NPI assigned
- Mar 19, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MA27453 | FL | MD | Naturopath |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Naturopath | 175F00000X | MA27453 | FL | Yes |
Addresses
Primary practice location
21 Old Kings Rd N Ste 215
Palm Coast, FL 32137-8254
Mailing address
PO Box 352752
Palm Coast, FL 32135-2752
Phone (386) 212-6068
Other providers in Palm Coast, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.