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General NPI Number Information
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NPI Number | 1932132818
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Entity Type | Individual
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Provider Name | THOMAS MICHAEL GRISCHOW O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 01/14/2025
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Provider Practice Location Address
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Address Line | 4060 N RIVER RD NE
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City | WARREN
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State | OH
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Zip | 44484-1039
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Country | US
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Telephone | 330-746-7691
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Fax |
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Provider Business Mailing Address
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Address Line | 10 DUTTON DR SUITE 200
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City | YOUNGSTOWN
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State | OH
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Zip | 44502-1818
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Country | US
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Telephone | 330-746-7691
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Fax | 330-743-8368
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT004457
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License Number State | OH
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