Individual
MICHELL MCDIFFETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4200 PARK AVE, ASHTABULA, OH 44004-6895
(216) 280-4363
Mailing address
1996 E 228TH ST, EUCLID, OH 44117-2044
(216) 280-4363
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
003207
OH
Other
Enumeration date
11/30/2010
Last updated
11/30/2010
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