Organization
EASTSIDE FAMILY PRACTICE, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NANCY L. GRAESSER D.O. (OWNER)
(614) 864-6107
Entity
Organization
Contact information
Practice address
11299 STONECREEK DR, PICKERINGTON, OH 43147-8910
(614) 235-4782
Mailing address
1835 DRUGAN CT SW, REYNOLDSBURG, OH 43068-8181
(614) 864-6107
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34004238
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0722061
—
OH
Enumeration date
02/05/2007
Last updated
08/22/2020
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