Individual
MR. GREGORY LLOYD SPROUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
16 HERBSTER ST, COLUMBIANA, OH 44408-1145
(330) 482-0161
Mailing address
16 HERBSTER ST, COLUMBIANA, OH 44408-1145
(330) 482-0161
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN084417
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2290435
—
OH
Enumeration date
10/16/2006
Last updated
07/09/2007
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