Individual
MATTHEW DAVID GRUCELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1333 N CARPENTER RD, BRUNSWICK, OH 44212-3178
(330) 741-3407
(330) 741-4037
Mailing address
1486 WATERBURY RD, LAKEWOOD, OH 44107-4817
(216) 241-3210
(216) 241-2458
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5309
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2345939
—
OH
Enumeration date
09/11/2006
Last updated
11/04/2019
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