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Individual

MISS IVORY GRACE DUDLEY-WILSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
19617 NITRA AVE, MAPLE HEIGHTS, OH 44137-1708
(216) 532-4919
Mailing address
19617 NITRA AVE, MAPLE HEIGHTS, OH 44137-1708
(216) 532-4919

Taxonomy

Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
RV798416
OH

Other

Enumeration date
04/18/2022
Last updated
04/25/2022
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