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Organization
OLYMPIA MEDICAL CLINIC
Active
Organization
OLYMPIA MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUBEN T AGRA M.D. (DOCTOR)
(216) 441-0660
Entity
Organization
Contact information
Practice address
3361 E 55TH ST, CLEVELAND, OH 44127-1547
(216) 441-0660
(216) 441-0660
Mailing address
3361 E 55TH ST, CLEVELAND, OH 44127-1547
(216) 441-0660
(216) 441-0660
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35034747
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0719824
—
OH
Enumeration date
09/23/2014
Last updated
09/23/2014
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