Individual
KIM COLEGROVE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12501 MADISON AVE, LAKEWOOD, OH 44107-5004
(216) 287-1358
Mailing address
3566 WARREN RD, CLEVELAND, OH 44111-3039
(216) 287-1358
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
33.015190
OH
Other
Enumeration date
04/28/2014
Last updated
04/28/2014
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