Provider Demographics
NPI:1447432083
Name:CHRISTINE GRALEY OD LLC
Entity type:Organization
Organization Name:CHRISTINE GRALEY OD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:GRALEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:440-346-4864
Mailing Address - Street 1:14894 N STATE AVE
Mailing Address - Street 2:
Mailing Address - City:MIDDLEFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44062-9724
Mailing Address - Country:US
Mailing Address - Phone:440-632-1695
Mailing Address - Fax:888-614-3113
Practice Address - Street 1:14894 N STATE AVE
Practice Address - Street 2:
Practice Address - City:MIDDLEFIELD
Practice Address - State:OH
Practice Address - Zip Code:44062-9724
Practice Address - Country:US
Practice Address - Phone:440-632-1695
Practice Address - Fax:888-614-3113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2018-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5551/T2465152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty