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Individual

BETHANY CAY GRIDLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
915 OLENTANGY RIVER RD, SUITE 2000, COLUMBUS, OH 43212-3153
(614) 293-8155
(614) 293-3565
Mailing address
700 ACKERMAN RD, SUITE 570, COLUMBUS, OH 43202-1559
(614) 293-8155
(614) 293-3565

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50.003298
OH
363AM0700X
Medical Physician Assistant
Primary
50.003298
OH
363AS0400X
Surgical Physician Assistant
50.003298
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0083981
OH
Enumeration date
07/26/2011
Last updated
05/09/2017
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