Provider Demographics
NPI:1720157134
Name:GRALEY, CHRISTINE RYAN (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTINE
Middle Name:RYAN
Last Name:GRALEY
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 ALLYND BLVD
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-1013
Mailing Address - Country:US
Mailing Address - Phone:440-346-4864
Mailing Address - Fax:
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
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5551 T2465152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist