Organization
CONSULTANTS IN LABORATORY MEDICINE OF GREATER TOLEDO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL C. GRATTENDICK (VICE PRESIDENT)
(561) 626-5512
Entity
Organization
Contact information
Practice address
2142 N COVE BLVD, TOLEDO, OH 43606-3895
(419) 534-3500
(419) 534-2608
Mailing address
11025 RCA CENTER DRIVE, SUITE 300, PALM BEACH GARDENS, FL 33410-4269
(561) 626-5512
(561) 626-4530
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0738474
—
OH
05
—
2574815
—
MI
Enumeration date
03/16/2006
Last updated
05/12/2016
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