Organization
HIS GRACE MEDICAL LLC
Active
Other names
6055 Cleveland Avenue
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FEYISAYO OLUWATOSIN TOLANI (RN/OFFICE MANAGER)
(614) 315-1836
Entity
Organization
Contact information
Practice address
6055 CLEVELAND AVE, COLUMBUS, OH 43231-2256
(614) 315-1836
(888) 491-4030
Mailing address
6055 CLEVELAND AVE, COLUMBUS, OH 43231-2256
(614) 315-1836
(888) 491-4030
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
35084618
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2509020
—
OH
Enumeration date
11/05/2007
Last updated
01/22/2014
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