Individual
GREGORY C INGRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
111 S 3RD ST, MARIETTA, OH 45750-3111
(740) 373-2069
(740) 373-2069
Mailing address
111 S 3RD ST, MARIETTA, OH 45750-3111
(740) 373-2069
(740) 373-2069
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3244
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0394210
—
OH
Enumeration date
07/12/2006
Last updated
01/09/2014
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