Individual
LAGRACRA CHINCHILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4435 ORANGEBERRY DR, GROVECITY, OH 43123
(614) 981-3170
Mailing address
4435 ORANGEBERRY DR, GROVE CITY, OH 43123-7930
(614) 981-3170
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
372154640194
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2874144
—
OH
Enumeration date
08/07/2014
Last updated
08/07/2014
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