Individual
MRS. DIANN ELLEN BORTHWICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9129 PRELOG LN, KIRTLAND, OH 44094-5182
(440) 256-9129
Mailing address
9129 PRELOG LN, KIRTLAND, OH 44094-5182
(440) 256-9129
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50001360
OH
Other
Enumeration date
03/28/2006
Last updated
05/02/2011
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