Individual
MRS. RACHAEL ELIZABETH GRUENBAUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14235 HIDDEN FARMS RD, PLAIN CITY, OH 43064-9726
(614) 352-1794
Mailing address
14235 HIDDEN FARMS RD, PLAIN CITY, OH 43064-9726
(614) 352-1794
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RS133103
DRIVERS LICENSE
OH
Enumeration date
02/16/2023
Last updated
02/16/2023
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