Individual
PATRICIA D GRACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3551 N RIDGE RD E, WALMART VISION CENTER, ASHTABULA, OH 44004
(440) 998-4014
(440) 998-4017
Mailing address
3551 N RIDGE RD E, WALMART VISION CENTER, ASHTABULA, OH 44004-4313
(440) 998-4014
(440) 998-4017
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
4254
OH
152W00000X
Optometrist
Primary
T865
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
20132
SPECTERA
OH
01
—
52935
DAVIS VISION
OH
01
—
552359
NVA
OH
01
—
729418
OPTICHOICE
OH
01
—
GR729418
CLARITY
OH
Enumeration date
09/07/2006
Last updated
07/08/2007
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