Individual
NANCY GRUENEWALD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
18788 NATIONAL TRAILS HWY, ORO GRANDE, CA 92368-9577
(760) 403-0049
Mailing address
PO BOX 1337, VICTORVILLE, CA 92393-1337
(760) 403-0049
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
L7161
CA
Other
Enumeration date
04/18/2019
Last updated
04/18/2019
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