| Doctor Name: | BROOKE LANELL GRAY |
| NPI Number: | 1043550080 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | D.O. |
| License Number: | OS 12281 |
| Business Practice Address: | Hht 4-7 Cav Unit # 15141 Apo, AP - 96224 |
| Business Phone Number: | 01033080117 |
| Business Fax Number: | |
| Mailing Address: | Hht 4-7 Cav, Unit # 15141 APO |
| State: | AP |
| Postal Code: | 96224 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 02/28/2013 |
| NPI Last Update Date: | 08/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | OS 12281 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |