Individual
MICHELLE GILLUM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
315 N IRELAND BLVD, ONTARIO, OH 44906-2218
(419) 564-4236
Mailing address
315 N IRELAND BLVD, ONTARIO, OH 44906-2218
(419) 564-4236
Taxonomy
Speciality
Code
Description
License number
State
376J00000X
Homemaker
Primary
—
—
Other
Enumeration date
10/16/2023
Last updated
10/16/2023
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