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Individual

BRIAN G DYKO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CNP

Contact information

Practice address
29101 HEALTH CAMPUS DR BLDG 2, WESTLAKE, OH 44145-5270
(440) 250-0325
(440) 250-0467
Mailing address
24701 EUCLID AVE, EUCLID, OH 44117-1714
(440) 250-0325
(440) 250-0467

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP05430
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2532969
OH
Enumeration date
07/12/2006
Last updated
07/29/2011
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