Individual
DR. BARRY L. GRIDLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2525 FAR HILLS AVE, OAKWOOD, OH 45419-1505
(937) 298-0550
(937) 298-5404
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3121/T1009
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0248057
—
OH
Enumeration date
09/16/2006
Last updated
12/23/2021
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