Individual
STEPHANIE MARIE CORLEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
607 LAKE AVE, ASHTABULA, OH 44004-3262
(440) 964-2035
Mailing address
2419 W 11TH ST, ASHTABULA, OH 44004-2545
(440) 813-3438
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
5853
OH
2255A2300X
Athletic Trainer
Primary
1015
OH
Other
Enumeration date
01/09/2019
Last updated
01/09/2019
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