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1265762017
TAMARA GRIGALTCHIK
NORTH PORT, FL
NPI
1265762017
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171000000X Military Health Care Provider
(Licence: FL 6906380)
Enumeration Date
2009-12-29
Last Update Date
2009-12-29
Business Address
Mrs. TAMARA GRIGALTCHIK
12105 MADRID AVE
NORTH PORT, FL 34287-1123
Phone number: 941-423-0019
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Mailing Address
Mrs. TAMARA GRIGALTCHIK
12105 MADRID AVE
NORTH PORT, FL 34287-1123
Phone number: 941-423-0019
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