Most Relevant Information
Provider Data
| NPI Number: | 1003403692 |
| Provider Name: | GWENDOLYN R GRAHN |
| Entity Type: | Individual |
| Taxonomy Code: | 374U00000X |
| Specialty: | Home Health Aide |
| License Number: | 5718742 |
Most Important Dates
| Enumeration Date: | 12/29/2020 |
| Last Updated: | 12/29/2020 |
Provider Practice Location
5078 FAR HILLS AVE
KETTERING
OH
454292308
Practice Location Phone/Fax
| Phone: | 6165481002 |
| Fax: |
Provider Mailing Location
5078 FAR HILLS AVE
KETTERING
OH
454292308
Provider Mailing Phone/Fax
| Phone: | 6165481002 |
| Fax: |