Individual
DIAMOND WELLS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15902 ELBERTA AVE, CLEVELAND, OH 44128-3255
(216) 219-9128
Mailing address
15902 ELBERTA AVE, CLEVELAND, OH 44128-3255
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
02/06/2021
Last updated
02/06/2021
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