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Organization
SELF
Active
Organization
SELF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY ELIZABETH MOENICH PA-C (PHYSICIAN ASSISTANT)
(440) 539-0929
Entity
Organization
Contact information
Practice address
7627 KEY WEST DR, PARMA, OH 44134-6624
(440) 539-0929
Mailing address
7627 KEY WEST DR, PARMA, OH 44134-6624
(440) 539-0929
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
004508
OH
261QU0200X
Urgent Care Clinic/Center
Primary
085.005738
IL
Other
Enumeration date
12/07/2015
Last updated
12/07/2015
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