Individual
DOMINICA JOZELLE GRILLOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
1101 N VANDEMARK RD, SIDNEY, OH 45365-3567
(937) 492-8080
(937) 492-2533
Mailing address
3888 CARMEL CHURCH RD, CELINA, OH 45822-9769
(567) 644-2707
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN 118988 M IV
OH
Other
Enumeration date
08/02/2012
Last updated
08/02/2012
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