Self-Employed
NPI #1689077125 in Painesville, Ohio
Provider Information
- NPI Number
- 1689077125
- Entity Type
- Organization
- Organization Name
- Self-Employed
- Primary Specialty
- Physiological Laboratory
- Enumeration Date
- Sep 29, 2014
- Last Updated
- Sep 29, 2014
Practice Location
- Address
- 95B BARLEY DR
- City
- Painesville
- State
- Ohio
- ZIP Code
- 44077-5349
- Phone
- (440) 251-9701
Authorized Official
- Name
- DELMESHA JACKSON, HOMEHEALTH
- Title
- STNA
- Phone
- (440) 251-9701
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physiological Laboratory |
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