Individual
MS. MARY R GRUMELOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1950 HAVEMANN RD, CELINA, OH 45822-9300
(419) 584-0615
(419) 584-0637
Mailing address
1950 HAVEMANN RD, CELINA, OH 45822-9300
(419) 584-0615
(419) 584-0637
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
OP.017212-S
OH
Other
Enumeration date
02/22/2023
Last updated
02/22/2023
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