Self

NPI #1740655471 in Parma, Ohio

Provider Information

NPI Number
1740655471
Entity Type
Organization
Organization Name
Self
Primary Specialty
Clinic/Center - Urgent Care
Enumeration Date
Dec 7, 2015
Last Updated
Dec 7, 2015

Practice Location

Address
7627 KEY WEST DR
City
Parma
State
Ohio
ZIP Code
44134-6624
Phone
(440) 539-0929

Authorized Official

Name
MARY ELIZABETH MOENICH, PA-C
Title
PHYSICIAN ASSISTANT
Phone
(440) 539-0929

Specialties & Taxonomy Codes

Specialty
Clinic/Center - Urgent CareUrgent Care

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